Anclam, Keith R.

Anclam, Keith R. is an individual health care provider with primary practice located at 323 S 18Th Ave , Sturgeon Bay WI 54235-1401. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Anclam, Keith R. can be contacted via phone (920) 746-0510.

Contact Information

Primary practice address
323 S 18Th Ave Sturgeon Bay WI 54235-1401
Phone: (920) 746-0510
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 27906 Wisconsin
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 27906 Wisconsin

Profile Details

NPI number 1487662037
LBN Legal business name Anclam, Keith R.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Apr 28th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487662037 NPPES
Wisconsin MEDICAID 30027400
Wisconsin Other 27906

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