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Individual
STEPHEN D KEEN
Active
Individual
STEPHEN D KEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
721
SC
363A00000X
Physician Assistant
A721
SC
363AM0700X
Medical Physician Assistant
A721
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1583PA
—
SC
Enumeration date
03/29/2010
Last updated
11/27/2020
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