Provider Demographics
NPI:1619591724
Name:SELLMAN, KATHRYN GORDON (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:GORDON
Last Name:SELLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 W LABURNUM AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-4357
Mailing Address - Country:US
Mailing Address - Phone:804-354-8108
Mailing Address - Fax:804-354-8075
Practice Address - Street 1:2104 W LABURNUM AVE STE 207
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4357
Practice Address - Country:US
Practice Address - Phone:804-354-8108
Practice Address - Fax:804-354-8075
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101283491207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine