Healthcare Provider Details

I. General information

NPI: 1346211240
Provider Name (Legal Business Name): KEITH MCATEER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 03/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BAY STATE CT
BREWSTER MA
02631-2120
US

IV. Provider business mailing address

19 BAY STATE CT
BREWSTER MA
02631-2120
US

V. Phone/Fax

Practice location:
  • Phone: 508-255-2325
  • Fax: 508-255-0015
Mailing address:
  • Phone: 508-255-2325
  • Fax: 508-255-0015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number70584
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: