Provider Demographics
NPI:1710904750
Name:KEITH H. WHARTON MD PC
Entity Type:Organization
Organization Name:KEITH H. WHARTON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:HAMILTON
Authorized Official - Last Name:WHARTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-775-0800
Mailing Address - Street 1:3572 BRODHEAD RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-3101
Mailing Address - Country:US
Mailing Address - Phone:724-775-0800
Mailing Address - Fax:724-775-8038
Practice Address - Street 1:3572 BRODHEAD RD
Practice Address - Street 2:SUITE 301
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-3101
Practice Address - Country:US
Practice Address - Phone:724-775-0800
Practice Address - Fax:724-775-8038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty