Individual
DR. BEENA JENNIFER PREMKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 JACKSON ST, FREDERICKSBURG, VA 22401-5719
(540) 373-3223
(540) 371-3753
Mailing address
600 JACKSON ST, FREDERICKSBURG, VA 22401-5719
(540) 373-3223
(540) 371-3753
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
0101264489
VA
2084P0804X
Child & Adolescent Psychiatry Physician
T-3193
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08380581
—
MS
Enumeration date
04/14/2014
Last updated
01/15/2019
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