Provider Demographics
NPI:1003907098
Name:KEESEE, SEAN T (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:T
Last Name:KEESEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-777-1096
Mailing Address - Fax:603-580-7210
Practice Address - Street 1:5 ALUMNI DR FL 2
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2128
Practice Address - Country:US
Practice Address - Phone:603-580-7525
Practice Address - Fax:603-580-7542
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21815207R00000X
NH18838207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001753005OtherBLUE CROSS BLUE SHEILD
WV7717666OtherAETNA
NH3112693Medicaid
WV3810002628Medicaid
WV3810002628Medicaid
WV7717666OtherAETNA
WV4158072Medicare PIN