Marill, Keith Austin
Marill, Keith Austin is an individual health care provider with primary practice located at 55 Fruit St , Boston MA 02114-2696. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Marill, Keith Austin can be contacted via phone (617) 643-8595.Contact Information
Primary practice address
55 Fruit St
Boston MA 02114-2696
Phone: (617) 643-8595
Fax: (617) 724-0917
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 214889 | Massachusetts |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 214889 | Massachusetts |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD448123 | Pennsylvania |
Profile Details
| NPI number | 1073503371 |
|---|---|
| LBN Legal business name | Marill, Keith Austin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | May 24th, 2019 - about 7 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 | 1073503371 | NPPES |
| Massachusetts | Other | J24824 | BCBS MA |
| Massachusetts | Other | 451736 | BCBS MA |
| Massachusetts | MEDICAID | 0199010 | BCBS MA |
Popular Providers
-
Anderson, Philip D
1 Deaconess Rd Bidmc Dept Of Emergency Medicine, Boston MA 02215-5321 -
Fleegler, Eric William
300 Longwood Ave Children'S Hospital Boston, Boston MA 02115 -
Noble, Vicki E
55 Fruit St Cln 115, Boston MA 02114-2621 -
Benzer, Theodore
55 Fruit St Zero Emerson Place Suite 3B, Boston MA 02114-2621 -
Miller, Emily S
0 Emerson Pl Suite 3B, Boston MA 02114-2241 -
Takayesu, James Kimo
5 Emerson Place, Mgh Emergency Associates, Boston MA 02114 -
Chan, Jennifer Lisa
10 Vining St Neville House, Boston MA 02115-6114 -
Berg, Evan R
1 Boston Medical Ctr Pl , Boston MA 02118-2908