Keith Sumner Albertson, M.D.

Individual provider Active NPI Specialist · Manassas, VA

NPI 1265459341 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1265459341
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
Practice address
9379 Forestwood LN
Manassas, VA 20110-4701
Phone
(703) 393-1667
Fax
(703) 361-2429
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
174400000XVAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Keith S Albertson MD PC Specialist Past
since May 1, 2005
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X VA Yes

Addresses

Primary practice location

9379 Forestwood LN
Manassas, VA 20110-4701

Mailing address

9379 Forestwood LN
Manassas, VA 20110-4701
Phone (703) 393-1667

Other providers in Manassas, VA

All providers in Manassas, VA · Specialist in Virginia

Sources for this page

Verify at the official NPI Registry.