Provider Demographics
NPI:1407849862
Name:KEISTER, DREW MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DREW
Middle Name:MICHAEL
Last Name:KEISTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:1730 CHEW ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5549
Practice Address - Country:US
Practice Address - Phone:610-969-3500
Practice Address - Fax:610-969-3509
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD434233207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine