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Individual

RONALD EDWARD KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1307 FEDERAL ST, SUITE 101, PITTSBURGH, PA 15212-4769
(412) 231-6550
(412) 231-6697
Mailing address
4135 BOARDMAN CANFIELD RD, SUITE 101, CANFIELD, OH 44406-9803
(330) 286-5330
(330) 286-5396

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
RN308280COA1
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
RN316539L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000547845
ANTHEM BCBS
OH
05
101457049
PA
05
2442182
OH
01
8241401
MEDICARE PTAN
OH
01
H172870
MEDICARE PTAN
OH
01
KE1756956
HIGHMARK BCBS
PA
01
P00401820
MEDICARE RAILROAD
PA
01
P01321181
MEDICARE RAILROAD
OH
Enumeration date
03/11/2006
Last updated
10/22/2014
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