Provider Demographics
NPI:1962815498
Name:KEADY, MONICA L (DPM)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:L
Last Name:KEADY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:L
Other - Last Name:COONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:3974 SPRINGFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-4119
Mailing Address - Country:US
Mailing Address - Phone:804-273-1717
Mailing Address - Fax:804-368-0242
Practice Address - Street 1:5311 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2041
Practice Address - Country:US
Practice Address - Phone:804-273-1717
Practice Address - Fax:804-368-0242
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01617213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery