Individual
DR. MARTIN S KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV SURG PED, STE 2A, SAINT LOUIS, MO 63110-1002
(314) 454-6022
(314) 454-2442
Mailing address
1 CHILDRENS PL, STE 6110, MSC 8235-49-6110, SAINT LOUIS, MO 63110-1002
(314) 454-6022
(314) 454-2442
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
042-0015839
VT
2086S0120X
Pediatric Surgery Physician
Primary
106695
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205096605
—
MO
Enumeration date
09/12/2006
Last updated
08/02/2022
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