Provider Demographics
NPI:1467475756
Name:KESLIN, MICHAEL H (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:KESLIN
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 2154
Mailing Address - Street 2:
Mailing Address - City:SKYLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28776-2154
Mailing Address - Country:US
Mailing Address - Phone:828-575-2644
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:6100 PAN AMERICAN EAST FWY NE
Practice Address - Street 2:SUITE 330
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3427
Practice Address - Country:US
Practice Address - Phone:505-856-2735
Practice Address - Fax:505-856-2749
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM70-148207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM10001051OtherLOVELACE
NMNM001R88OtherBLUE CROSS BLUE SHIELD
NM7286515OtherAETNA
NM24950Medicaid
NM3545500OtherCIGNA
NMNM0012Q04OtherBLUE CROSS BLUE SHIELD
NM34P718001OtherMEDICARE PTAN
NM202020906OtherPRESBYTERIAN
NM2665015OtherUNITED HEALTH CARE
NM10733OtherHMN
NM343731801OtherMEDICARE PTAN
NMPROVP13821OtherMOLINA
A23298Medicare UPIN