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Individual

MR. KEVIN MICHAEL WEMYSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9226
(804) 734-9562
Mailing address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9226
(804) 734-9562

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005570
VA
363A00000X
Physician Assistant
1066163

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000335800
FL
Enumeration date
10/18/2005
Last updated
06/05/2023
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