Individual
SHARESE DELOIS JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 DENBIGH BLVD, NEWPORT NEWS, VA 23608-4415
(757) 283-8300
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 822-4355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101272462
VA
Other
Enumeration date
04/18/2018
Last updated
08/05/2021
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