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Individual

DR. CHARLES ROBERT KELLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1383 W HUNTER ST, LOGAN, OH 43138-1013
(740) 385-0202
(740) 380-2734
Mailing address
PO BOX 228, LOGAN, OH 43138-0228
(740) 385-0202
(740) 380-2734

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
34003787
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0565240
OH
Enumeration date
08/31/2006
Last updated
11/23/2020
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