Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 0101271650 | VA |
NPI | 1073909958 |
---|---|
Provider Name | Kevin Edward Todd JR. |
First Address | Virginia Beach, VA 23455-4369 |
Second Address | Cincinnati, OH 45229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 19/11/2021 |