National Provider Identifier

Keith Balram Shankar, M.D.

Keith Balram Shankar, M.D. is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Dunkirk, NY and a listed phone number of (716) 363-6960.

NPI 1225657364Dunkirk, NYFamily Medicine Physician

Profile Overview

NPI
1225657364
Provider Type
Individual
Primary Specialty
Family Medicine Physician
Enumeration Date
April 09, 2020
Last Updated
December 05, 2023

Practice Location

  • 3898 Vineyard Dr Ste 1
  • Dunkirk, NY 14048-3559

Phone: (716) 363-6960

Mailing Address

  • PO Box 488
  • Buffalo, NY 14240-0488

Specialties

  • Family Medicine Physician (207Q00000X)
Full Record
NPI
1225657364
Entity Type
Individual
Last Name
Shankar
First Name
Keith
Middle Name
Balram
Name Prefix
Dr.
Credential
M.D.
Mailing Street Address
PO Box 488
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14240-0488
Mailing Country
US
Mailing Phone
(716) 852-4772
Practice Street Address
3898 Vineyard Dr Ste 1
Practice City
Dunkirk
Practice State
NY
Practice ZIP Code
14048-3559
Practice Country
US
Practice Phone
(716) 363-6960
Enumeration Date
April 09, 2020
Last Updated
December 05, 2023
Deactivation Date
January 10, 2022
Reactivation Date
January 25, 2022
Sex
Male
Sole Proprietor
No
Certification Date
December 05, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Medicine Physician (207Q00000X)