Antevil, Jared Lee
Antevil, Jared Lee is an sole proprietor health care provider with primary practice located at 620 John Paul Jones Cir Dept Of Ct Surgery, Naval Medical Center Portsmouth, Portsmouth VA 23708-2197. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Antevil, Jared Lee can be contacted via phone (757) 953-2489.Contact Information
Primary practice address
620 John Paul Jones Cir Dept Of Ct Surgery, Naval Medical Center Portsmouth
Portsmouth VA 23708-2197
Phone: (757) 953-2489
Fax: (757) 953-2489
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 0101246647 | Virginia |
Profile Details
| NPI number | 1871578534 |
|---|---|
| LBN Legal business name | Antevil, Jared Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 14th, 2005 |
| Last updated | Apr 25th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871578534 | NPPES |
| Virginia | MEDICAID | 1871578534 |
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