Provider Demographics
NPI:1952373565
Name:KEEN, TAMARA ANN (DC)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:ANN
Last Name:KEEN
Suffix:
Gender:F
Credentials:DC
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Mailing Address - Street 1:9601 PULASKI PARK DR
Mailing Address - Street 2:SUITE 416
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1409
Mailing Address - Country:US
Mailing Address - Phone:410-933-5678
Mailing Address - Fax:410-933-1823
Practice Address - Street 1:2511 EDISON HWY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1629
Practice Address - Country:US
Practice Address - Phone:410-675-4500
Practice Address - Fax:410-675-4556
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2015-05-28
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Provider Licenses
StateLicense IDTaxonomies
MDS01720111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU55446Medicare UPIN