Provider Demographics
NPI:1609196880
Name:MCKEON, DANA RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:RENEE
Last Name:MCKEON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:RENEE
Other - Last Name:HOMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45067 LEMONT RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2985
Mailing Address - Country:US
Mailing Address - Phone:989-225-0628
Mailing Address - Fax:
Practice Address - Street 1:3901 BEAUBIEN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2119
Practice Address - Country:US
Practice Address - Phone:313-745-5535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096317208600000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208600000XAllopathic & Osteopathic PhysiciansSurgery