Individual
SUZANNE B KEEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-4796
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
44200
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G880250
BLUE SHIELD
CA
05
—
00G880250
—
CA
05
—
054930400
—
MN
01
—
WG88025A
MEDICARE PTAN
CA
Enumeration date
02/10/2006
Last updated
12/10/2020
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