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:
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Health care specialties

SpecialtyCodeLicense #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 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871578534 NPPES
Virginia MEDICAID 1871578534

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