Provider Demographics
NPI:1518087873
Name:RAYMOND, KEITH ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ALLEN
Last Name:RAYMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ARAMCO BOX 1344
Mailing Address - Street 2:
Mailing Address - City:ABQAIQ
Mailing Address - State:EASTERN PROVINCE
Mailing Address - Zip Code:31311
Mailing Address - Country:SA
Mailing Address - Phone:0119663-572-6812
Mailing Address - Fax:0119663-577-2619
Practice Address - Street 1:4830 GLEN HOLLOW LN NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-8738
Practice Address - Country:US
Practice Address - Phone:828-441-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800369207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2636495OtherAETNA HMO
NC8911499Medicaid
NC5994701OtherAETNA NONHMO
NC0410292252OtherME #
NC11499OtherBLUE CROSS
NCB1853OtherMEDCOST
NC365250OtherMAMSI
NC365250OtherMAMSI
NC365250OtherMAMSI
NCG76858Medicare UPIN