Healthcare Provider Details

I. General information

NPI: 1366625048
Provider Name (Legal Business Name): GEORGE M KEMP MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 FIRST COLONIAL RD SUITE 202
VIRGINIA BEACH VA
23454-2418
US

IV. Provider business mailing address

1120 FIRST COLONIAL RD SUITE 202
VIRGINIA BEACH VA
23454-2418
US

V. Phone/Fax

Practice location:
  • Phone: 757-481-0327
  • Fax: 757-481-6730
Mailing address:
  • Phone: 757-481-0327
  • Fax: 757-481-6730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: GINNY B RUSSO
Title or Position: OFFICE MANAGER
Credential:
Phone: 757-481-0327