Provider Demographics
NPI:1629073192
Name:KEYSER, RONALD EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:EDWARD
Last Name:KEYSER
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 1:1302 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-3108
Mailing Address - Country:US
Mailing Address - Phone:240-313-3223
Mailing Address - Fax:240-313-3396
Practice Address - Street 1:1302 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-3108
Practice Address - Country:US
Practice Address - Phone:240-313-3223
Practice Address - Fax:240-313-3396
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD-05632208000000X, 2080A0000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Not Answered2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM-04819OtherCDS #
MDD05632OtherPHYSICIAN LICENSE - MD
MDD05632OtherPHYSICIAN LICENSE - MD
78096Medicare UPIN
MDD05632OtherPHYSICIAN LICENSE - MD