Provider Demographics
NPI:1457533812
Name:DR MATTHEW J KEAST LTD
Entity Type:Organization
Organization Name:DR MATTHEW J KEAST LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:KEAST
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:703-820-3200
Mailing Address - Street 1:6319 CASTLE PL
Mailing Address - Street 2:3B
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-1907
Mailing Address - Country:US
Mailing Address - Phone:703-820-3200
Mailing Address - Fax:703-752-4049
Practice Address - Street 1:6319 CASTLE PL
Practice Address - Street 2:3B
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-1907
Practice Address - Country:US
Practice Address - Phone:703-820-3200
Practice Address - Fax:703-752-4049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103001008213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADB0673OtherMEDICARE RAILROAD CARRIER
5354050001Medicare NSC
DCG01346Medicare PIN