Provider Demographics
NPI:1386936888
Name:KEILMAN, DANIEL PATRICK
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PATRICK
Last Name:KEILMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 WAYNE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1723
Mailing Address - Country:US
Mailing Address - Phone:919-731-7105
Mailing Address - Fax:919-734-5517
Practice Address - Street 1:2203 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1723
Practice Address - Country:US
Practice Address - Phone:919-731-7105
Practice Address - Fax:919-734-5517
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24624183500000X
WAPH60156213183500000X
NV15756183500000X
PARP446512183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist