Individual
STEPHEN KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1130 N BALDWIN AVE, MARION, IN 46952-2536
(765) 660-7480
(765) 382-4495
Mailing address
330 N WABASH, STE G20, MARION, IN 46952-2600
(765) 660-7600
(765) 651-7313
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
173346
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201290930
—
IN
Enumeration date
04/26/2011
Last updated
09/27/2018
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