Individual
DR. JUAN C BETETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-6366
(757) 953-6056
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-6366
(757) 953-6056
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101239136
VA
208000000X
Pediatrics Physician
15929
MS
208000000X
Pediatrics Physician
2009-01512
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119596
—
MS
Enumeration date
09/12/2005
Last updated
12/06/2021
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