Organization
KHADIJAH Y. JORDAN, MD.,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHADIJAH Y JORDAN M.D. (PRESIDENT)
(757) 436-2424
Entity
Organization
Contact information
Practice address
111 MEDICAL PKWY, SUITE 202, CHESAPEAKE, VA 23320-0302
(757) 436-2424
(757) 436-6628
Mailing address
111 MEDICAL PKWY, SUITE 202, CHESAPEAKE, VA 23320-0302
(757) 436-2424
(757) 436-6628
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101052592
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010202531
—
VA
01
—
178986
ANTHEM
VA
01
—
2133107
MAMSI
—
01
—
24104
OPTIMA
VA
01
—
5025116
CIGNA
VA
Enumeration date
08/24/2006
Last updated
09/08/2009
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