Provider Demographics
NPI:1871529958
Name:GEIB, KEVIN SHANE (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:SHANE
Last Name:GEIB
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:148 LINDEN DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2818
Mailing Address - Country:US
Mailing Address - Phone:540-722-0627
Mailing Address - Fax:540-722-9533
Practice Address - Street 1:136 LINDEN DR
Practice Address - Street 2:SUITE 104
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2818
Practice Address - Country:US
Practice Address - Phone:540-678-3588
Practice Address - Fax:540-678-9025
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0101052888208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010049695Medicaid
VA00V926U01Medicare ID - Type Unspecified
VA010049695Medicaid