Healthcare Provider Details

I. General information

NPI: 1477064582
Provider Name (Legal Business Name): CAMERON JAMES KEEN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2017
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4620 WILLIAM PENN HWY
MURRYSVILLE PA
15668-2004
US

IV. Provider business mailing address

6001 KINGDOM CT
MURRYSVILLE PA
15668-2631
US

V. Phone/Fax

Practice location:
  • Phone: 412-403-1183
  • Fax:
Mailing address:
  • Phone: 412-403-1183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA14316
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: