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Individual

DR. JONATHAN ROBERT DETTMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5269
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5269

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25940
NE
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/10/2009
Last updated
08/30/2024
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