Individual
KEENAN C. WANAMAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7085 SYDNEY CURV, MONTGOMERY, AL 36117-3509
(334) 246-4774
(334) 246-2450
Mailing address
7085 SYDNEY CURV, MONTGOMERY, AL 36117-3509
(334) 246-4774
(334) 246-2450
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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