Healthcare Provider Details

I. General information

NPI: 1730823998
Provider Name (Legal Business Name): PATRICK EDWARD KEUL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 PROFESSIONAL PARK DR STE 101
KANNAPOLIS NC
28081-8638
US

IV. Provider business mailing address

270 COPPERFIELD BLVD NE STE 202
CONCORD NC
28025-2441
US

V. Phone/Fax

Practice location:
  • Phone: 704-938-6521
  • Fax:
Mailing address:
  • Phone: 704-721-2060
  • Fax: 704-403-0470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2025-01775
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: