1467475756 NPI number — MICHAEL H KESLIN M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467475756 NPI number — MICHAEL H KESLIN M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

KESLIN

Provider First Name:

MICHAEL

Provider Middle Name:

H

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1467475756

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

11/11/2015

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 2154

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

SKYLAND

Provider Business Mailing Address State Name:

NC

Provider Business Mailing Address Postal Code:

28776-2154

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

828-575-2644

Provider Business Mailing Address Fax Number:

828-350-2174

Provider First Line Business Practice Location Address:

6100 PAN AMERICAN EAST FWY NE

Provider Second Line Business Practice Location Address:

SUITE 330

Provider Business Practice Location Address City Name:

ALBUQUERQUE

Provider Business Practice Location Address State Name:

NM

Provider Business Practice Location Address Postal Code:

87109-3427

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

505-856-2735

Provider Business Practice Location Address Fax Number:

505-856-2749

Provider Enumeration Date:

07/26/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207K00000X , with the licence number:  70-148 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 10001051 . This is a "LOVELACE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: NM001R88 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 7286515 . This is a "AETNA" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 24950 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
• Identifier: 3545500 . This is a "CIGNA" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: NM0012Q04 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 34P718001 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 202020906 . This is a "PRESBYTERIAN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 2665015 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 10733 . This is a "HMN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 343731801 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: PROVP13821 . This is a "MOLINA" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".