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Individual

DR. KEVIN CHARLES HARRISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
9460 AMBERDALE DRIVE, SUITE C, RICHMOND, VA 23236
(804) 276-2470
(804) 276-2473
Mailing address
9460 AMBERDALE DRIVE, SUITE C, RICHMOND, VA 23236
(804) 276-2470
(804) 276-2473

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0102201098
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
142999
ANTHEM PROVEDIER #
VA
Enumeration date
08/09/2005
Last updated
09/30/2009
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