Individual
ROMAN HYSTAD KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1990 CONNECTICUT AVE S, SARTELL, MN 56377-2554
(320) 257-5595
(320) 257-5596
Mailing address
PO BOX 7366, SAINT CLOUD, MN 56302-7366
(320) 257-7787
(320) 257-5596
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
4420
OK
2085R0202X
Diagnostic Radiology Physician
Primary
52680
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982743159
—
MN
Enumeration date
02/05/2007
Last updated
08/11/2011
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