Organization
PAUL J KEANE DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET PRESSLEY (OFFICE MANAGER)
(704) 289-3338
Entity
Organization
Contact information
Practice address
506 S SUTHERLAND AVE, MONROE, NC 28112-5061
(704) 289-3338
(704) 283-1597
Mailing address
506 S SUTHERLAND AVE, MONROE, NC 28112-5061
(704) 289-3338
(704) 283-1597
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08153
BCBS
—
01
—
2700114
EVERCARE
—
05
—
8908153
—
NC
01
—
P00102841
MEDICARE RR
—
Enumeration date
05/19/2008
Last updated
10/29/2009
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