Individual
DR. JESSE W ST CLAIR III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1708 OLD DONATION PARKWAY, VIRGINIA BEACH, VA 23454-3064
(757) 395-5300
(757) 213-9341
Mailing address
PO BOX 7068, PORTSMOUTH, VA 23707-0068
(757) 686-3516
(757) 686-0230
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101032201
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-001
TRICARE/CHAMPUS
VA
05
—
006055486
—
VA
01
—
0555R
BCBS
NC
01
—
10015738
SENTARA OPTIMA
VA
05
—
1477502250
—
VA
01
—
248020
ANTHEM
VA
01
—
259556
ANTHEM BCBS
VA
01
—
35080
OPTIMA/SENTARA
VA
01
—
428960
UHC/MAMSI
VA
05
—
890555R
—
NC
01
—
PAR
MULTIPLAN
VA
Enumeration date
05/09/2006
Last updated
12/01/2016
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