Dijkstra, Jacob Willem E

Dijkstra, Jacob Willem E is an individual health care provider with primary practice located at 9500 Euclid Ave , Cleveland OH 44195-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Dijkstra, Jacob Willem E can be contacted via phone (800) 223-2273.

Contact Information

Primary practice address
9500 Euclid Ave Cleveland OH 44195-0001
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 35050126D Ohio

Profile Details

NPI number 1659335354
LBN Legal business name Dijkstra, Jacob Willem E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2006
Last updated Jan 30th, 2008 - about 16 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 1659335354 NPPES
Ohio MEDICAID 0622651

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