Keibel, Martin Mark
Keibel, Martin Mark is an sole proprietor health care provider with primary practice located at 574 Middle Tpke E , Manchester CT 06040-3730. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Keibel, Martin Mark can be contacted via phone (860) 646-4334.Contact Information
Primary practice address
574 Middle Tpke E
Manchester CT 06040-3730
Phone: (860) 646-4334
Fax: (860) 646-7020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 023567 | Connecticut |
Profile Details
| NPI number | 1427067339 |
|---|---|
| LBN Legal business name | Keibel, Martin Mark |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 7th, 2006 |
| Last updated | Oct 31st, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427067339 | NPPES |
| Connecticut | Other | P00064445 | MEDICARE RR |
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