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General NPI Number Information
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NPI Number | 1528245347
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Entity Type | Individual
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Provider Name | TATIANA BORISOVNA KECK MD
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Gender | Female
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 933 FIRST COLONIAL RD STE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3172
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Country | US
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Telephone | 757-491-7359
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Fax | 757-491-9359
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Provider Business Mailing Address
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Address Line | 933 FIRST COLONIAL RD STE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3172
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Country | US
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Telephone | 757-491-7359
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Fax | 757-491-9359
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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 | 51231
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 0101255588
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 101255588
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License Number State | VA
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