MEDICARE: DR. MONICA L KEADY DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	01617	MD

General Provider Information

NPI Number	:	1962815498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONICA L KEADY DPM

Provider Business Mailing Address
First Line	:	3974 SPRINGFIELD RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-4119
Country	:	US
Telephone Number	:	804-273-1717
Fax Number	:	804-368-0242

Provider Business Practice Location Address
First Line	:	5311 PATTERSON AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-2041
Country	:	US
Telephone Number	:	804-273-1717
Fax Number	:	804-368-0242

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2014
Last Update Date	:	10/05/2022

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