MEDICARE: KEENAN CASWELL

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
1	208D00000X	General Practice Physician	1700646841	MD

General Provider Information

NPI Number	:	1700646841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEENAN CASWELL

Provider Business Mailing Address
First Line	:	8901 WISCONSIN AVE
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20889-0004
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8901 WISCONSIN AVE
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20889-0004
Country	:	US
Telephone Number	:	301-295-0537
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2024
Last Update Date	:	12/08/2025

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