Organization
VALLEY DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH A KNOELL M.D. (OWNER)
(540) 221-6702
Entity
Organization
Contact information
Practice address
2611 W MAIN ST, SUITE 1, WAYNESBORO, VA 22980-1600
(540) 221-6702
(540) 221-6704
Mailing address
2611 W MAIN ST, SUITE 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
—
101058582
VIRGINIA STATE MEDICAL LICENSE
—
01
—
11180924
CAQH
—
Enumeration date
07/12/2016
Last updated
03/07/2023
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