Provider Demographics
NPI:1396702197
Name:KEITER, KAREL A (DO)
Entity type:Individual
Prefix:
First Name:KAREL
Middle Name:A
Last Name:KEITER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:875 SOUTH ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5036
Mailing Address - Country:US
Mailing Address - Phone:717-652-1107
Mailing Address - Fax:717-652-1142
Practice Address - Street 1:4315 LONDONDERRY ROAD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5036
Practice Address - Country:US
Practice Address - Phone:717-909-0290
Practice Address - Fax:717-909-0292
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS006867L207Q00000X, 207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012060820006Medicaid
PA0012060820008Medicaid
PA0012060820005Medicaid
PA0012060820006Medicaid
E79114Medicare UPIN