Basic Information
| Provider Information | |||||||||
| NPI: | 1073650685 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KEKU | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 204 CATES FARM RD | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275167766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199327129 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 W HAMLET AVE | ||||||||
| Address2: | |||||||||
| City: | HAMLET | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283454522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102058171 | ||||||||
| FaxNumber: | 8003053233 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 09/29/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 93-00181 | NC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.