Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 0102201803 | VA |
N | 207Q00000X | Family Doctor | 0102201803 | VA |
NPI | 1235183195 |
---|---|
Provider Name | Dr. Sarah J Steele-Killeen |
First Address | Salem, VA 24153-8050 |
Second Address | Salem, VA 24153-3816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 17/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010243998 | (05) | VA |
3810004626 | (05) | WV |
H73911 | (02) |