Individual
KENNETH EDWARD ANSELMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5453 GOVERNOR GC PEERY HWY, RAVEN, VA 24639
(276) 963-0895
(276) 963-0897
Mailing address
PO BOX 236, DORAN, VA 24612
(276) 963-0895
(276) 963-0897
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101028748
VA
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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