Basic Information
| Provider Information | |||||||||
| NPI: | 1205928876 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KELLER | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9007 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229069007 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 501 SUNSET LN | ||||||||
| Address2: | |||||||||
| City: | CULPEPER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 227013917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408294100 | ||||||||
| FaxNumber: | 5408295001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2006 | ||||||||
| LastUpdateDate: | 07/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 0101042235 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | RF7F81 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | 01010462235 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207RA0001X | 0101042235 | VA | Y |
ID Information
| ID | Type | State | Issuer | Description | 40159 | 01 | OPTIMUM CHOICE | OTHER | 541977219 | 01 | UNITED HEALTHCARE | OTHER | 0004 | 01 | CAREFIRST | OTHER | 40159 | 01 | MDIPA | OTHER | 060058383 | 01 | RAILROAD MEDICARE | OTHER | 432666 | 01 | ANTHEM | OTHER | 958360 | 01 | AETNA HMO | OTHER | 40159 | 01 | ALLIANCE GEHA | OTHER | 541977219 | 01 | TRICARE | OTHER | 4120244 | 01 | AETNA PPO MC | OTHER | 432667 | 01 | ANTHEM HEALTHKEEPERS PLUS | OTHER | P00025866 | 01 | RAILROAD MEDICARE | OTHER | 00V370C96 | 01 | MEDICARE OF VA | OTHER | 541977219 | 01 | CIGNA | OTHER | 40159 | 01 | MAMSI | OTHER | 505382 | 01 | NCPPO | OTHER | 541977219 | 01 | NALC AFFORDABLE | OTHER |