Provider Demographics
NPI:1457351835
Name:KEATING, FRIEDERIKE KYRA (MD)
Entity Type:Individual
Prefix:DR
First Name:FRIEDERIKE
Middle Name:KYRA
Last Name:KEATING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FRIEDERIKE
Other - Middle Name:KYRA
Other - Last Name:VON ZUR MUHLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1063
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05402-1063
Mailing Address - Country:US
Mailing Address - Phone:802-847-3734
Mailing Address - Fax:802-847-3637
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-3734
Practice Address - Fax:802-847-3734
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT341688OtherMVP
VT58511OtherBC/BS