Provider Demographics
NPI:1427269620
Name:KEOGAN, MARY (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:KEOGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF RADIOLOGY
Mailing Address - Street 2:ST JAMES HOSPITAL
Mailing Address - City:DUBLIN
Mailing Address - State:DUBLIN
Mailing Address - Zip Code:8
Mailing Address - Country:IE
Mailing Address - Phone:01-416-2765
Mailing Address - Fax:
Practice Address - Street 1:ST JAMES HOSPITAL
Practice Address - Street 2:JAMES STREET
Practice Address - City:DUBLIN
Practice Address - State:DUBLIN
Practice Address - Zip Code:8
Practice Address - Country:IE
Practice Address - Phone:01-416-2765
Practice Address - Fax:01-454-9225
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1582172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology