Provider Demographics
NPI:1154397289
Name:KEEFE, BRIAN M (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:M
Last Name:KEEFE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:25 STANFORD ST
Practice Address - Street 2:PLAZA LEVEL ERICH LINDEMANN MENTAL HEALTH CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-6004
Practice Address - Fax:617-626-8669
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2011-02-14
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Provider Licenses
StateLicense IDTaxonomies
MA2087022084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0183440Medicaid
MA453167OtherTUFTS HEALTH PLAN
MAJ25501OtherBCBS MA
MAJ25501OtherBCBS MA
MA453167OtherTUFTS HEALTH PLAN