Provider Demographics
NPI:1700853066
Name:KEEFE, STEPHEN D (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:KEEFE
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 1:11842 ROCK LANDING DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4437
Mailing Address - Country:US
Mailing Address - Phone:757-873-0338
Mailing Address - Fax:866-283-1052
Practice Address - Street 1:11842 ROCK LANDING DR STE 100
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4437
Practice Address - Country:US
Practice Address - Phone:757-873-0338
Practice Address - Fax:866-283-1052
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043485207YS0123X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
184357OtherANTHEM
P00274985OtherMEDICARE RAILROAD
F30325Medicare UPIN
184357OtherANTHEM