Healthcare Provider Details

I. General information

NPI: 1528528098
Provider Name (Legal Business Name): MEGHAN LEA KEANE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 INDUSTRIAL PARK RD
SACO ME
04072-1804
US

IV. Provider business mailing address

13 INDUSTRIAL PARK RD
SACO ME
04072-1804
US

V. Phone/Fax

Practice location:
  • Phone: 207-283-8800
  • Fax: 207-613-2566
Mailing address:
  • Phone: 207-283-8800
  • Fax: 207-613-2566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD30415
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0066058
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: