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General NPI Number Information
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NPI Number | 1366426348
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Entity Type | Individual
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Provider Name | DR. PAUL W KEOUGH
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Gender | Male
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 135 WEBSTER ST
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City | HANOVER
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State | MA
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Zip | 02339-1200
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Country | US
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Telephone | 781-878-7020
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Fax | 781-871-3590
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Provider Business Mailing Address
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Address Line | 15 WOODBRIDGE RD
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City | HINGHAM
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State | MA
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Zip | 02043-3144
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 54115
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License Number State | MA
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