Provider Demographics
NPI:1316696560
Name:TARGET, KEISHA PATRICIA (MD)
Entity type:Individual
Prefix:
First Name:KEISHA
Middle Name:PATRICIA
Last Name:TARGET
Suffix:
Gender:F
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:ROCKLEY GOLF & COUNTRY CLUB, GOLF CLUB ROAD
Mailing Address - Street 2:APT 225 GOLDEN GROVE CLUSTER
Mailing Address - City:BRIDGETOWN
Mailing Address - State:CHRIST CHURCH
Mailing Address - Zip Code:BB15121
Mailing Address - Country:BB
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:58 SILVER MOON DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1249
Practice Address - Country:US
Practice Address - Phone:954-305-6594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program