Provider Demographics
NPI:1467489336
Name:KELLERMANN, ARTHUR LODGE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:LODGE
Last Name:KELLERMANN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
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Mailing Address - Street 1:4301 JONES BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4712
Mailing Address - Country:US
Mailing Address - Phone:301-295-3016
Mailing Address - Fax:301-295-3542
Practice Address - Street 1:4301 JONES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4712
Practice Address - Country:US
Practice Address - Phone:301-295-3016
Practice Address - Fax:404-295-3542
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG89040207P00000X
MDD79941207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAB59020Medicare UPIN