Provider Demographics
NPI:1609172782
Name:SCHLUP, KEYNA I (MD)
Entity type:Individual
Prefix:
First Name:KEYNA
Middle Name:I
Last Name:SCHLUP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5938 US HIGHWAY 93 S
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-8415
Mailing Address - Country:US
Mailing Address - Phone:406-863-9300
Mailing Address - Fax:406-863-9301
Practice Address - Street 1:5938 US HIGHWAY 93 S
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-8415
Practice Address - Country:US
Practice Address - Phone:406-863-9300
Practice Address - Fax:406-863-9301
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0052853207Q00000X
WY9070A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT200020982Medicaid
CO66684331Medicaid