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Individual

DR. MICHAEL RAYMOND KEVERLINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3206 CHURCHLAND BLVD, CHESAPEAKE, VA 23321-5206
(757) 484-0101
(757) 484-0515
Mailing address
3206 CHURCHLAND BLVD, CHESAPEAKE, VA 23321-5206
(757) 484-0101
(757) 484-0515

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101230614
VA
332H00000X
Eyewear Supplier
7010360
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010080371
VA
01
102064
ANTHEM BCBS
VA
01
2174956
UNITED HEALTH CARE
VA
01
29717
OPTIMA
VA
01
399105
MAMSI
VA
01
4773409
CIGNA
VA
01
7827286
AETNA
VA
05
8906674
NC
Enumeration date
07/15/2005
Last updated
05/08/2008
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