Individual
STACEY J KEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7253 AMBASSADOR RD., BALTIMORE, MD 21244-2714
(443) 436-1114
Mailing address
9708 OAK HILL DR, ELLICOTT CITY, MD 21042-6334
(410) 740-2866
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D32450
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
546871000
—
MD
Enumeration date
03/08/2006
Last updated
01/15/2014
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