Healthcare Provider Details

I. General information

NPI: 1225654858
Provider Name (Legal Business Name): DOMINIQUE N MCKEEVER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 E EVESHAM RD STE 103
VOORHEES NJ
08043-1557
US

IV. Provider business mailing address

2225 E EVESHAM RD STE 103
VOORHEES NJ
08043-1557
US

V. Phone/Fax

Practice location:
  • Phone: 856-247-7600
  • Fax:
Mailing address:
  • Phone: 856-247-7600
  • Fax: 856-247-7575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC1-0024962
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA11033600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: