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Individual

DR. KEITH B BOYKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10701 ROSEMARY DR, MANASSAS, VA 20109-7282
(703) 257-3001
(703) 257-3057
Mailing address
KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP, 2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101043500
VA
208000000X
Pediatrics Physician
D0072534
MD
208000000X
Pediatrics Physician
MD039283
DC

Other

Enumeration date
12/01/2006
Last updated
11/23/2011
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