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Individual

MS. GRACE L. KEENAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D., CEO

Contact information

Practice address
21785 FILIGREE CT, SUITE 100, ASHBURN, VA 20147-6213
(703) 554-1100
(703) 554-1110
Mailing address
21785 FILIGREE CT, SUITE 100, ASHBURN, VA 20147-6213
(703) 554-1100
(703) 554-1110

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101041478
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1770518821
VA
Enumeration date
07/11/2006
Last updated
02/23/2016
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