Keller, Marc I

Keller, Marc I is an individual health care provider with primary practice located at 206 Summit St , Burlington VT 05401. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Keller, Marc I can be contacted via phone (802) 862-3239.

Contact Information

Primary practice address
206 Summit St Burlington VT 05401
Phone: (802) 862-3239
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 042.0005602 Vermont
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 02.0005602 Vermont

Profile Details

NPI number 1124039128
LBN Legal business name Keller, Marc I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Apr 1st, 2020 - about 6 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 1124039128 NPPES
Vermont MEDICAID 0004733
Vermont MEDICAID 30010121

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