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Individual

ROBERT MICHAEL KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
5 FIRST VILLAGE DR, PINEHURST, NC 28374-8724
(910) 295-6831
(910) 295-0244
Mailing address
PO BOX 2000, PINEHURST, NC 28370-2000
(910) 295-6831
(910) 295-0244

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
103335
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12586
BCBS NC
05
8912586
NC
01
P00102532
RAILROAD MEDICARE
Enumeration date
07/28/2006
Last updated
07/22/2011
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