Individual
KEITH ALLEN KNOELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2611 W MAIN ST STE 1, WAYNESBORO, VA 22980-1600
(540) 221-6702
(540) 221-6704
Mailing address
2611 W MAIN ST STE 1, WAYNESBORO, VA 22980-1600
(540) 221-6702
(540) 221-6704
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
101058582
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396748109
ANTHEM
VA
05
—
1902258064
—
VA
01
—
3910782
CIGNA
VA
01
—
5159805
AETNA
VA
01
—
812009361
VIRGINIA HEALTH NETWORK
VA
Enumeration date
05/24/2005
Last updated
10/05/2016
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