Breckenridge, Jamielou Custodio
Breckenridge, Jamielou Custodio is an individual health care provider with primary practice located at 9300 Dewitt Loop , Fort Belvoir VA 22060-5285. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Breckenridge, Jamielou Custodio can be contacted via phone (571) 231-3224.Contact Information
Primary practice address
9300 Dewitt Loop
Fort Belvoir VA 22060-5285
Phone: (571) 231-3224
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 0101276676 | Virginia |
Profile Details
| NPI number | 1679010896 |
|---|---|
| LBN Legal business name | Breckenridge, Jamielou Custodio |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2017 |
| Last updated | Apr 24th, 2024 - about 5 months 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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