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Individual

DR. KIMBERLEE H OVERDECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1112 SHIPMAN LANE, MCLEAN, VA 22101-2137
(703) 556-6466
(703) 556-8881
Mailing address
111 OAKWOOD RD, EAST PEORIA, IL 61611-1853
(309) 740-4272

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101240648
VA
2085R0202X
Diagnostic Radiology Physician
036-134226
IL
2085R0202X
Diagnostic Radiology Physician
D0061784
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447240155
VA
05
1452068
LA
Enumeration date
10/24/2005
Last updated
11/27/2023
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