Provider Demographics
NPI:1295039402
Name:KEENAN, WILLIAM JOSEPH (CPHT, NRP)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:KEENAN
Suffix:
Gender:M
Credentials:CPHT, NRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8858 WALTHAM WOODS RD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2402
Mailing Address - Country:US
Mailing Address - Phone:410-882-8825
Mailing Address - Fax:410-882-8841
Practice Address - Street 1:8858 WALTHAM WOODS RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-2402
Practice Address - Country:US
Practice Address - Phone:410-882-8825
Practice Address - Fax:410-882-8841
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1750109146L00000X
MDT07045183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic