Provider Demographics
NPI:1518112895
Name:MCKEEVER, MATTHEW OWEN (PA-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:OWEN
Last Name:MCKEEVER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:96 SHERRI DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914
Mailing Address - Country:US
Mailing Address - Phone:215-822-2019
Mailing Address - Fax:215-829-2478
Practice Address - Street 1:800 SPRUCE ST
Practice Address - Street 2:3B ORTHOPAEDICS, 1 CATHCART
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6130
Practice Address - Country:US
Practice Address - Phone:215-829-2222
Practice Address - Fax:215-829-2478
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002945L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical