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Individual

KEENAN C. WANAMAKER

Active
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Individual

KEENAN C. WANAMAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
3721
AZ
208600000X
Surgery Physician
DO-900
AL
2086S0129X
Vascular Surgery Physician
Primary
3721
AZ

Other

Enumeration date
06/16/2005
Last updated
05/10/2021
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