Healthcare Provider Details
I. General information
NPI: 1336231463
Provider Name (Legal Business Name): JOSEPH SEBASTIAN DEJAMES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/28/2006
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
MYRAH KEATING SMITH COMMUNITY HEALTH CENTER 3-B SUSSANABERG
ST.JOHN VI
00831
US
IV. Provider business mailing address
P.O. BOX 1385
ST. JOHN VI
00831
VG
V. Phone/Fax
- Phone: 340-693-8900
- Fax: 340-693-9506
- Phone: 340-777-4637
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 208265 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 208265 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | 1149 |
| License Number State | VI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: