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General NPI Number Information
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NPI Number | 1477723260
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Entity Type | Individual
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Provider Name | LUDMILA MARIE KISSI M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 14800 LEE HWY
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City | GAINESVILLE
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State | VA
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Zip | 20155-1842
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Country | US
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Telephone | 703-743-7017
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 COX RD
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City | GLEN ALLEN
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State | VA
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Zip | 23060-9263
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Country | US
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Telephone | 804-968-5700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101236996
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License Number State | VA
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