Provider Demographics
NPI:1063494599
Name:KEESHIN, NEAL DAVID (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:DAVID
Last Name:KEESHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 PAGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03570-3531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:59 PAGE HILL RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-3531
Practice Address - Country:US
Practice Address - Phone:603-752-2200
Practice Address - Fax:603-326-5999
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10535207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH798923OtherMVP
VT00019226OtherBCBS OF VT
VT8002134OtherLADIES FIRST
NHRE5150OtherNHIC
NH30200153Medicaid
NH0106910YPNH02OtherBCBS OF NH
NH0100480OtherCIGNA
NHAA61275OtherHPHC
VTOVN0721Medicaid
NHF36584Medicare UPIN
VTOVN0721Medicaid