Dr. Brian J. Keroack MD
Specialist in Portland, ME(View on Map)
Full Name
Dr. Brian J Keroack MD
NPI Number
1891788659
NPI Type
Individual Provider
Gender
Male
Enumeration Date
08/26/2005
Specialties
(Taxonomies)Licenses
State
Maine
License Number
013245
Contact
Information
Purpose
Mailing
Location
Address
51 SEWALL ST
51 SEWALL ST
City
Portland
Portland
State
ME
ME
Postal Code
04102-2643
04102-2643
Country
US
US
Telephone Number
(207) 774-5761
(207) 774-5761
Identifiers
Identifier
0673610001
269530099
660000685
Identifier State
ME
ME
ME
Identifier Issuer
DMERC
Unknown
PALMETTO RAILROAD MEDICARE
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 10/09/2008