Keroack, Myles David

Keroack, Myles David is an individual health care provider with primary practice located at 2116 Craig Rd , Eau Claire WI 54701-6149. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Keroack, Myles David can be contacted via phone (715) 858-4500.

Contact Information

Primary practice address
2116 Craig Rd Eau Claire WI 54701-6149
Phone: (715) 858-4500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 72672 Massachusetts
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 72672 Massachusetts
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 55795 Wisconsin

Profile Details

NPI number 1013998582
LBN Legal business name Keroack, Myles David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Jul 6th, 2011 - about 15 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 1013998582 NPPES
Massachusetts Other J10606 BCBS MA
Massachusetts Other 072672 BCBS MA
Massachusetts MEDICAID 3088898 BCBS MA

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