Individual
JENNIFER G DEDIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1060 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-3002
(757) 491-9065
(757) 395-6321
Mailing address
PO BOX 7068, PORTSMOUTH, VA 23707-0068
(757) 686-3508
(757) 686-0541
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101235063
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010122457
—
VA
05
—
1306900980
—
VA
Enumeration date
12/20/2006
Last updated
12/15/2021
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