Individual
DR. JAN JACOB DEKKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD,PHD,FACS
Contact information
Practice address
8316 ARLINGTON BLVD, SUITE 410, FAIRFAX, VA 22031-5207
(703) 573-6985
(703) 573-7154
Mailing address
PO BOX 546, MERRIFIELD, VA 22116-0546
(703) 573-6985
(703) 573-7154
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101039002
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7312610
—
VA
Enumeration date
06/10/2006
Last updated
01/26/2018
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