Provider Demographics
NPI:1306089750
Name:KEATING, ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:KEATING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3171 44TH ST S UNIT 101
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8521
Mailing Address - Country:US
Mailing Address - Phone:701-235-0561
Mailing Address - Fax:701-235-0330
Practice Address - Street 1:3171 44TH ST S UNIT 101
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-1940
Practice Address - Country:US
Practice Address - Phone:701-235-0561
Practice Address - Fax:701-235-0330
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA239091207W00000X
ND10073207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND15370Medicaid
NDN715284Medicare PIN