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Individual

DUSTIN THOMAS KEENAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-S

Contact information

Practice address
14 RICHLAND MEDICAL PARK DR STE 200, COLUMBIA, SC 29203-6882
(803) 296-7846
(803) 296-9699
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3510
SC
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
05/02/2019
Last updated
02/26/2026
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