Individual
KEVIN KEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 JOHNNIE DODDS BLVD, MOUNT PLEASANT, SC 29464-3231
(843) 881-4325
Mailing address
PO BOX 65598, CHARLOTTE, NC 28265-0598
(843) 881-4325
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12020
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120201
—
SC
Enumeration date
11/03/2006
Last updated
06/30/2008
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