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General NPI Number Information
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NPI Number | 1902193980
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Entity Type | Individual
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Provider Name | KELVIN D KEMP MD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 3700 FETTLER PARK DR
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City | DUMFRIES
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State | VA
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Zip | 22025-2050
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Country | US
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Telephone | 703-441-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 22 TANKARD RD
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City | STAFFORD
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State | VA
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Zip | 22554-6548
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Country | US
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Telephone | 586-838-0832
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101256795
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License Number State | VA
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