Individual
ASHIF K JETHAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13855 VILLAGE PLACE DRIVE, MIDLOTHIAN, VA 23114
(804) 464-1028
(804) 464-2931
Mailing address
671-B HIOAKS ROAD, RICHMOND, VA 23225-4072
(804) 272-5814
(804) 560-0232
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
049340
CT
207R00000X
Internal Medicine Physician
262848
MA
207RN0300X
Nephrology Physician
Primary
0101264655
VA
208M00000X
Hospitalist Physician
049340
CT
390200000X
Student in an Organized Health Care Education/Training Program
262848
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669632782
—
VA
Enumeration date
06/12/2008
Last updated
12/27/2024
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