Individual
DR. KATHLEEN MARIE CLELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13135 LEE JACKSON MEMORIAL HWY STE 305, FAIRFAX, VA 22033-1907
(703) 359-8640
(703) 591-6105
Mailing address
13135 LEE JACKSON MEMORIAL HWY STE 305, FAIRFAX, VA 22033-1909
(703) 359-8640
(703) 591-6105
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101244015
VA
208D00000X
General Practice Physician
22398
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060320900
—
DC
05
—
1528039708
—
VA
05
—
651060400
—
MD
Enumeration date
01/27/2006
Last updated
10/31/2021
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