Provider Demographics
NPI:1215973805
Name:STAHL, KEITH A (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:STAHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:26 TWIN BROOK LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4722
Mailing Address - Country:US
Mailing Address - Phone:603-663-7340
Mailing Address - Fax:603-663-7333
Practice Address - Street 1:199 MANCHESTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-5232
Practice Address - Country:US
Practice Address - Phone:603-663-8718
Practice Address - Fax:603-314-4554
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2021-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH9145207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH9145OtherSTATE MEDICAL LICENSE
NHF78192Medicare UPIN