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Individual

KAMAL SELIM LOUKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4867 BAXTER RD, SUITE 105, VIRGINIA BEACH, VA 23462-4469
(757) 473-9300
(757) 473-9361
Mailing address
4867 BAXTER RD, SUITE 105, VIRGINIA BEACH, VA 23462-4469
(757) 473-9300
(757) 473-9361

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101036392
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00W135E02
MEDICARE PROVIDER NUMBER
VA
05
5651719
VA
Enumeration date
05/17/2006
Last updated
10/24/2007
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