Healthcare Provider Details

I. General information

NPI: 1376505842
Provider Name (Legal Business Name): MATTHEW JOHN KEAST D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7440 SPRING VILLAGE DR
SPRINGFIELD VA
22150-4446
US

IV. Provider business mailing address

5730 EXECUTIVE DR STE 230
CATONSVILLE MD
21228-1762
US

V. Phone/Fax

Practice location:
  • Phone: 703-923-4644
  • Fax:
Mailing address:
  • Phone: 571-291-6131
  • Fax: 571-291-6135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0103001008
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0103001008
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: