Provider Demographics
NPI:1104022565
Name:KELLER, SARA C (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:C
Last Name:KELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ANN
Other - Last Name:CONDRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10751 FALLS RD
Mailing Address - Street 2:SUITE 412
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4517
Mailing Address - Country:US
Mailing Address - Phone:410-583-2900
Mailing Address - Fax:
Practice Address - Street 1:10751 FALLS RD
Practice Address - Street 2:SUITE 412
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4517
Practice Address - Country:US
Practice Address - Phone:410-583-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22260207R00000X
PAMD441311207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine