Provider Demographics
NPI:1588616783
Name:KIRBY, AMY B (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:B
Last Name:KIRBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:B
Other - Last Name:MATZELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11307 SUNSET HILLS RD STE B
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5279
Mailing Address - Country:US
Mailing Address - Phone:703-652-1200
Mailing Address - Fax:703-652-1200
Practice Address - Street 1:11307 SUNSET HILLS RD STE B
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5279
Practice Address - Country:US
Practice Address - Phone:703-652-1200
Practice Address - Fax:703-652-1200
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-236312085R0202X
OK224312085R0202X
TXU20802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology