Provider Demographics
NPI:1982789798
Name:KEERBS, AMANDA JANE (MD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:JANE
Last Name:KEERBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8528 ACORN CIR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-7007
Mailing Address - Country:US
Mailing Address - Phone:206-355-5277
Mailing Address - Fax:
Practice Address - Street 1:8901 ROCKVILLE PIKE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-4418
Practice Address - Country:US
Practice Address - Phone:800-526-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0072238207Q00000X
VA0101251163207QH0002X, 207Q00000X, 207QH0002X
DCMD040661390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
268210OtherINTERNAL ID-MOTOR VEHICLE ID
WA8279168Medicaid
053601OtherMEDICARE
MD130061000Medicaid
H20730Medicare UPIN
WA8279168Medicaid