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NPI Code Detail

MEDICARE: DR. ANDREW KEENAN M.D.

MEDICARE: DR. ANDREW KEENAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianD0026012MD
2207UN0903XIn Vivo & In Vitro Nuclear Medicine PhysicianD0026012MD
3207UN0902XNuclear Imaging & Therapy PhysicianD0026012MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467405175
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW KEENAN M.D.
Provider Business Mailing Address
First Line : 2831 MCDUFF DR
Second Line :
City : CHESAPEAKE BEACH
State : MD
Zip : 20732-3202
Country : US
Telephone Number : 410-703-3511
Fax Number :
Provider Business Practice Location Address
First Line : 901 HARRY S TRUMAN DR N
Second Line :
City : LARGO
State : MD
Zip : 20774-5477
Country : US
Telephone Number : 301-677-2149
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 06/23/2022

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