Healthcare Provider Details

I. General information

NPI: 1033046529
Provider Name (Legal Business Name): ROBERT SHAWN KEEBLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 WALNUT ST STE 620
PHILADELPHIA PA
19107-5005
US

IV. Provider business mailing address

833 CHESTNUT ST STE 210
PHILADELPHIA PA
19107-4405
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-6864
  • Fax: 215-955-2878
Mailing address:
  • Phone: 215-955-5638
  • Fax: 215-503-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: