Individual
KEAN O FEYZEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 GRESHAM DR, RALEIGH BUILDINE, SUITE #304, NORFOLK, VA 23507
(757) 388-3397
(757) 388-2885
Mailing address
825 FAIRFAX AVE., 6TH FLOOR, NORFOLK, VA 23507-2007
(757) 446-8937
(757) 446-8951
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101264443
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101264443
VIRGINIA STATE MEDICAL LICENSE
VA
Enumeration date
04/03/2014
Last updated
03/07/2023
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