Provider Demographics
NPI:1144726399
Name:KEENER, MARIANA (DO)
Entity type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:KEENER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 HUGUENOT RD STE 114
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2477
Mailing Address - Country:US
Mailing Address - Phone:804-415-7462
Mailing Address - Fax:804-207-8752
Practice Address - Street 1:1520 HUGUENOT RD STE 114
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2477
Practice Address - Country:US
Practice Address - Phone:804-415-7462
Practice Address - Fax:804-207-8752
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102205883207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine