Individual
AIDA KALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
236 CLEARFIELD AVE STE 215, VIRGINIA BEACH, VA 23462-1893
(757) 853-1380
Mailing address
PO BOX 639295 DEPT 93394, CINCINNATI, OH 45263-9295
(248) 434-6169
(855) 618-6655
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
0101232965
VA
208D00000X
General Practice Physician
Primary
0101232965
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005873916
—
VA
05
—
010056233
—
VA
Enumeration date
08/10/2006
Last updated
01/24/2024
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