Dr. Jared Lee Antevil M.D.

NPI 1871578534

Information of Dr. Jared Lee Antevil M.D.

The NPI 1871578534 is an Individual type. NPI No 1871578534 belongs to Jared Lee Antevil. Dr. Jared Lee Antevil M.D. specializes in Thoracic Surgery (Cardiothoracic Vascular Surgery). He is practising at 620 John Paul Jones Cir, Portsmouth, Virginia 23708. You can also contact him via phone number (757) 953-2489.

Practice address located

  • 620 John Paul Jones Cir
  • Portsmouth, Virginia 23708
  • (757) 953-2489
  • (757) 953-2489

Mailling address located

  • 620 John Paul Jones Circle
  • Portsmouth, Virginia 23708
  • (757) 953-2489
  • (757) 953-0811
Dr. Jared Lee Antevil M.D. is PECOS enrolled.
NPI No 1871578534
Primary Taxonomy
Specialty of the provider
PrimaryTaxonomy CodeClassificationLicense NumberLicense State
Yes208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)0101246647Virginia
Identifier for this provider
StateIdentifierTypeIssuer
VA1871578534Medicaidn/a
VAVAD000Medicare UPINn/a
VAVV8840BMedicare PINn/a
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