DR. CHARLES M KEOLEIAN MD NPI 1356325674

NPI Information

NPI: 1356325674
Provider Name: DR. CHARLES M KEOLEIAN, MD
Classification: Urology - 208800000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1040 DELAWARE AVE
MARION, OH
ZIP 43302
Phone: (740) 383-7950
Get Directions

DR. Charles M Keoleian, MD is an urology in Marion, OH with 35 years of experience. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. DR. Charles M Keoleian, MD NPI is 1356325674. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

1040 DELAWARE AVE
MARION, OH
ZIP 43302-416
Phone: (740) 383-7950
Fax: (740) 375-8164

The NPI 1356325674 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/30/2005 and was last updated on 7/17/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208800000X	Urology		35.140177	OHIO	Yes
2	208800000X	Urology		4301054366	MICHIGAN	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	340634410-1	OTHER	MICHIGAN	BCBSM INDIVIDUAL ID
2	4387203	MEDICAID	MICHIGAN
3	4973505	MEDICAID	MICHIGAN
4	G14839	OTHER	MICHIGAN	HAP
5	133384	OTHER	MICHIGAN	PREFERRED AND CARE CHOICE
6	5281117	OTHER	MICHIGAN	AETNA
7	340019725	OTHER	MICHIGAN	RAILROAD MEDICARE
8	CK054366	OTHER	MICHIGAN	BCBSM IDENTIFIER
9	10534	OTHER	MICHIGAN	MCARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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