Basic Information
Provider Information
NPI: 1235351461
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEUMAN
FirstName: KENLEY
MiddleName: W
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10710 MIDLOTHIAN TURNPIKE
Address2: SUITE 200
City: RICHMOND
State: VA
PostalCode: 232354759
CountryCode: US
TelephoneNumber: 8048972100
FaxNumber: 8048979074
Practice Location
Address1: 1212 KOGER CENTER BLVD
Address2:  
City: NORTH CHESTERFIELD
State: VA
PostalCode: 232354778
CountryCode: US
TelephoneNumber: 8048972100
FaxNumber: 8048979074
Other Information
ProviderEnumerationDate: 05/03/2007
LastUpdateDate: 01/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X0102201995VAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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