Jalazo, Jesse Brian
Jalazo, Jesse Brian is an individual health care provider with primary practice located at 1002 Sushruta Dr , Martinsburg WV 25401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Jalazo, Jesse Brian can be contacted via phone (304) 263-0913.Contact Information
Primary practice address
1002 Sushruta Dr
Martinsburg WV 25401
Phone: (304) 263-0913
Fax: (304) 267-2917
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 14159 | West Virginia |
Profile Details
| NPI number | 1134181688 |
|---|---|
| LBN Legal business name | Jalazo, Jesse Brian |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 3rd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1134181688 | NPPES |
| Other | 4403390 | AETNA | |
| MEDICAID | 0084592000 | AETNA |
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