Provider Demographics
NPI:1164868469
Name:BLEECHER, KIRA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRA
Middle Name:MARIE
Last Name:BLEECHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KIRA
Other - Middle Name:MARIE
Other - Last Name:FRIEDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4212 PARK PLACE CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3314
Mailing Address - Country:US
Mailing Address - Phone:804-332-5950
Mailing Address - Fax:804-728-1086
Practice Address - Street 1:4212 PARK PLACE CT
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3314
Practice Address - Country:US
Practice Address - Phone:804-332-5950
Practice Address - Fax:804-728-1086
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1012651542084A0401X
CT557392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine