Maxwell, Keegan Lawrence

Maxwell, Keegan Lawrence is an individual health care provider with primary practice located at 2351 Connecticut Ave S Suite 200, Sartell MN 56377-2477. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Maxwell, Keegan Lawrence can be contacted via phone (320) 259-1411.

Contact Information

Primary practice address
2351 Connecticut Ave S Suite 200 Sartell MN 56377-2477
Phone: (320) 259-1411
Fax: (320) 259-8967
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 12655 South Dakota
Allopathic & Osteopathic Physicians / Urology 208800000X 51197 Minnesota

Profile Details

NPI number 1790712883
LBN Legal business name Maxwell, Keegan Lawrence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Jul 8th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790712883 NPPES
Minnesota Other P00629856 RAILROAD MEDICARE
Minnesota MEDICAID 1790712883 RAILROAD MEDICARE

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