Deitrick, John C

Deitrick, John C is an individual health care provider with primary practice located at 1051 Johnston Willis Dr Ste 200, Richmond VA 23235. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Deitrick, John C can be contacted via phone (804) 320-2705.

Contact Information

Primary practice address
1051 Johnston Willis Dr Ste 200 Richmond VA 23235
Phone: (804) 320-2705
Fax: (804) 330-2433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 0101037598 Virginia

Profile Details

NPI number 1457338741
LBN Legal business name Deitrick, John C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2005
Last updated Jan 13th, 2010 - 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 1457338741 NPPES
Virginia MEDICAID 1457338741
Virginia MEDICAID 7354380

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