Individual
KELLY VIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3001 HOSPITAL DR, CHEVERLY, MD 20785-1189
(301) 618-2000
Mailing address
5550 COLUMBIA PIKE APT 1072, ARLINGTON, VA 22204-3164
(919) 906-8433
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/26/2014
Last updated
09/26/2014
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