Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Keith Gresham, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1063599215

Keith Gresham, MD is an Obstetrics/Gynecology in Englewood, New Jersey. Qualified in 1982, 44 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
44
Licensed in
NJ
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

177 N Dean St Ste 208
Englewood, NJ 07631-2533
Phone: (201) 569-0200
Fax: (201) 569-8287
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence MA49464 (NJ)

Record details

NPI number1063599215
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedNovember 1, 2006
Last updated in NPPESJuly 8, 2007
Mailing address177 N Dean St, Suite 208, Englewood, NJ 07631-2533

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 1982 (44 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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