Albemarle Square Family Healthcare Andy Macfarlan, M.D. - Mark Niehaus, M.D. - Jane Shaw, M.D. - Debbie Campbell, M.D. - Mary Whittemore, M.D. Kelly Maupin, F.N.P. - Kimberly Carter, NP-C 416 Albemarle Square Charlottesville, Virginia 22901 434-978-2126 Adult Review of Systems Name DOB Date CONCERNS YOU WOULD LIKE TO DISCUSS DURING YOUR VISIT:.