Provider Demographics
NPI:1235183195
Name:STEELE-KILLEEN, SARAH J (DO)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:J
Last Name:STEELE-KILLEEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4098 WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-8050
Mailing Address - Country:US
Mailing Address - Phone:540-384-6340
Mailing Address - Fax:
Practice Address - Street 1:103 E MAIN ST
Practice Address - Street 2:BLUE RIDGE OSTEOPATHIC MANIPULATIVE MEDICINE
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-3816
Practice Address - Country:US
Practice Address - Phone:540-384-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201803204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010243998Medicaid
WV3810004626Medicaid
009889C51Medicare PIN
WV3810004626Medicaid
H73911Medicare UPIN