Individual
DR. JORDAN DITCHEK
Active
Individual
DR. JORDAN DITCHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
ME81781
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME81781
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05109
BLUE CROSS BLUE SHIELD
FL
05
—
261786200
—
FL
Enumeration date
05/23/2005
Last updated
12/16/2021
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