Provider Demographics
NPI:1245423011
Name:KEITH, STEPHEN NORBERT (MD, MSPH)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:NORBERT
Last Name:KEITH
Suffix:
Gender:M
Credentials:MD, MSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 4TH ST NW
Mailing Address - Street 2:APT. 1011
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-4902
Mailing Address - Country:US
Mailing Address - Phone:410-733-6368
Mailing Address - Fax:
Practice Address - Street 1:811 4TH ST NW
Practice Address - Street 2:APT. 1011
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-4902
Practice Address - Country:US
Practice Address - Phone:410-733-6368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0036014208000000X
CAG37534208000000X
GA67665208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics