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Individual

DR. KEANE EMILE MCCULLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1601 E BROADWAY STE 100, COLUMBIA, MO 65201-5821
(573) 443-8796
(573) 443-8796
Mailing address
1601 E BROADWAY STE 100, COLUMBIA, MO 65201-5821
(573) 443-8796
(573) 443-0737

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20964
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NAD000
MEDICARE UPIN
Enumeration date
03/08/2018
Last updated
12/17/2025
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