Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | D22288 | MD |
NPI | 1053309930 |
---|---|
Provider Name | Robert D Keehn |
First Address | Baltimore, MD 21209-2230 |
Second Address | Baltimore, MD 21209-2230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2005 |
Last Update Date | 04/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C57445 | (02) |