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Contact Information

MYLES D KEROACK, MD
2116 CRAIG RD
EAU CLAIRE, WI54701-6149
 Phone: 715-858-4500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for MYLES D KEROACK · (Male)

NPI # 1013998582
Status Active
Credentials MD
Entity Individual
Enumeration date 11/10/2005
Last updated 07/06/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 72672
  • WI License # 55795
  • MA Medicaid 3088898
  • MA Other J10606 BCBS MA
  • MA Other 072672 TUFTS HEALTH PLAN
Hospital affiliation(s)
  • ELLIOT HOSPITAL - (Acute Care)
    1 ELLIOT WAY
    MANCHESTER, NH 03103
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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