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General NPI Number Information
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NPI Number | 1801867536
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Entity Type | Individual
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Provider Name | JERALD R JARVI PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | THE WHITE HOUSE MEDICAL UNIT
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City | WASHINGTON
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State | DC
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Zip | 20502-0001
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Country | US
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Telephone | 202-757-2476
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Fax |
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Provider Business Mailing Address
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Address Line | 4588 CHRISTIANA PARRAN RD
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City | CHESAPEAKE BEACH
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State | MD
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Zip | 20732-4040
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Country | US
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Telephone | 410-257-2965
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9101522
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License Number State | FL
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