Individual
DR. JONATHAN DENLEA MCDIVITT
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) 953-2277
Mailing address
1240 INDIA ST UNIT 802, SAN DIEGO, CA 92101-8532
(301) 305-1901
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101242092
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/19/2006
Last updated
11/22/2023
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