Individual
DAVID M KEADLE
Active
Individual
DAVID M KEADLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
20828
WV
2085R0202X
Diagnostic Radiology Physician
35086553
OH
2085R0202X
Diagnostic Radiology Physician
TP155
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000196626
UNISON
OH
01
—
001718787
MTN STATE BCBS
—
05
—
2575459
—
OH
05
—
3810002472
—
WV
01
—
50007261
PASSPORT
KY
01
—
55049337600
WORKMANS COMP
WV
05
—
6410045600
—
KY
01
—
7738308
AETNA
—
01
—
P00255847
RR MEDICARE (WV)
WV
Enumeration date
12/08/2005
Last updated
01/08/2010
Update your record
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