Healthcare Provider Details

I. General information

NPI: 1083796155
Provider Name (Legal Business Name): CATHERINE A. KEAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 05/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 ESTATE THOMAS PARAGON MEDICAL BUILDING SUITE 204
ST. THOMAS VI
00804
US

IV. Provider business mailing address

9149 SUGAR ESTATE STE 204
ST. THOMAS VI
00802
US

V. Phone/Fax

Practice location:
  • Phone: 340-777-5004
  • Fax: 340-777-1243
Mailing address:
  • Phone: 340-777-5004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1012
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: