Individual
A. BRIAN KELLEHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., P.C.
Contact information
Practice address
7101 JAHNKE RD, RICHMOND, VA 23225-4017
(804) 330-2000
Mailing address
5414 SUNRISE BLUFF CT, MIDLOTHIAN, VA 23112-2516
(804) 739-4879
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101027778
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005809983
—
VA
05
—
005810043
—
VA
01
—
114223
BLUE SHIELD
VA
01
—
114708
BLUE SHIELD
VA
Enumeration date
07/17/2006
Last updated
04/28/2008
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