Provider Demographics
NPI:1194793844
Name:NORWOOD, KEVIN GLEN (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:GLEN
Last Name:NORWOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5875 BREMO RD
Mailing Address - Street 2:MOB SOUTH SUITE 104
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1934
Mailing Address - Country:US
Mailing Address - Phone:804-281-8182
Mailing Address - Fax:804-281-8263
Practice Address - Street 1:5875 BREMO RD
Practice Address - Street 2:MOB SOUTH SUITE 104
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1934
Practice Address - Country:US
Practice Address - Phone:804-281-8182
Practice Address - Fax:804-281-8263
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2013-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD245792080P0207X
VA01012532152080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06778OtherGROUP PTAN
OR227047Medicaid
ORH65353Medicare UPIN
VAC06778OtherGROUP PTAN