Individual
MARIE KATHLEEN KETCHERSID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2232 WILBORN AVE, SOUTH BOSTON, VA 24592-1662
(434) 517-6180
(434) 517-6179
Mailing address
2232 WILBORN AVE, SOUTH BOSTON, VA 24592-1662
(434) 517-6180
(434) 517-6179
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101054916
VA
Other
Enumeration date
07/28/2006
Last updated
01/03/2011
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