Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 0102205765 | VA |
NPI | 1033617485 |
---|---|
Provider Name | Dr. John Michael Kerber |
First Address | Norfolk, VA 23551-2487 |
Second Address | Norfolk, VA 23551-2111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2018 |
Last Update Date | 21/04/2020 |