Provider Demographics
NPI:1477554780
Name:MESLIN, KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:
Last Name:MESLIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 EVES DR
Mailing Address - Street 2:SUITE 120A
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3135
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0346
Practice Address - Street 1:200 BOWMAN DR STE E66
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9623
Practice Address - Country:US
Practice Address - Phone:856-247-7295
Practice Address - Fax:856-247-7118
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430195208600000X, 208C00000X
NJ25MA07881400208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0079987Medicaid
NJ092160Medicare ID - Type Unspecified