| Doctor Name: | MICHAEL C KELLER |
| NPI Number: | 1033186804 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | N005226 |
| Business Practice Address: | 103 Hurley Ave Kingston, NY - 12401 |
| Business Phone Number: | 8453394191 |
| Business Fax Number: | 8453316894 |
| Mailing Address: | 103 Hurley Ave, KINGSTON |
| State: | NY |
| Postal Code: | 12401 |
| Phone Number: | 8453394191 |
| Fax Number: | 8453316894 |
| NPI Enumeration Date: | 03/01/2006 |
| NPI Last Update Date: | 02/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | N005226 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |