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General NPI Number Information
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NPI Number | 1427295294
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Entity Type | Individual
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Provider Name | JOHN E. JESUS M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 05/09/2017
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Provider Practice Location Address
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Address Line | 78 MEDICAL CENTER DR DEPARTMENT OF EMERGENCY MEDICINE
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City | FISHERSVILLE
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State | VA
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Zip | 22939-2332
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Country | US
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Telephone | 540-332-4423
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Fax |
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Provider Business Mailing Address
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Address Line | 785 CAITLIN DR
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City | CROZET
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State | VA
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Zip | 22932-9301
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Country | US
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Telephone | 703-937-7375
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 236103
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | C1-0009743
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License Number State | DE
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