Provider Demographics
NPI:1679567820
Name:ZAITOUN, KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:
Last Name:ZAITOUN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3235 ACADEMY AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-3200
Mailing Address - Country:US
Mailing Address - Phone:757-484-9400
Mailing Address - Fax:757-484-8809
Practice Address - Street 1:3235 ACADEMY AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-3200
Practice Address - Country:US
Practice Address - Phone:757-484-9400
Practice Address - Fax:757-484-8809
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2020-05-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101039811207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA058150OtherANTHEM BCBS
390002387OtherMCARE RAILROAD
VA6078354Medicaid
VA6078354Medicaid
390002387OtherMCARE RAILROAD