Individual
MS. SUSAN D KEWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
5899 BREMO RD, SUITE 100, RICHMOND, VA 23226-1935
(804) 288-8512
(804) 288-4552
Mailing address
1115 BOULDERS PKWY, SUITE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 560-9029
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001950
VA
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508832783
—
VA
01
—
P00630298
RAILROAD MEDICARE
VA
Enumeration date
02/27/2006
Last updated
09/02/2020
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