Individual
DR. KEITH D MUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4913 FAWN DELL RD, ROANOKE, VA 24018-8624
(540) 314-5568
Mailing address
4913 FAWN DELL RD, ROANOKE, VA 24018-8624
(540) 314-5568
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101223708
VA
208600000X
Surgery Physician
2020-03144
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007311206
—
VA
Enumeration date
08/19/2005
Last updated
09/08/2021
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