Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. WADE ROBERT KELLER, D.O.
ActiveDR. WADE ROBERT KELLER, D.O. is a Dermatology healthcare provider located in EAGLE, Idaho. NPI 1942402169 is currently active in the NPPES registry. Verify at CMS.
Dermatology · EAGLE, ID
Registration Details
- NPI Number
- 1942402169
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 1, 2007 (19.18446647389 yrs)
- Last Updated
- Nov 3, 2022
- Licenses
-
4692 (AZ)O-0559 (ID)O-0559 (ID)O-0559 (ID)
Practice Information
- Address
-
1605 E RIVERSIDE DREAGLE, ID, 836166237Browse ID providers · Browse ZIP 83616
- Phone
- 2089396227
- Fax
- 2089396442
- Primary Specialty
-
Dermatology
207N00000X
- Additional Specialty
- Obesity Medicine
- Additional Specialty
- Procedural Dermatology
- Additional Specialty
- Dermatology
Other Dermatology Providers in EAGLE, ID
| Name | Credential | NPI |
|---|---|---|
| HEATHER NICOLE KNUTSON | N.P. | 1215936034 |
| DR. GREGORY LYNN FLINT | M.D. | 1699866822 |
| DR. GABRIEL GUERRERO | D.O. | 1184080210 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.