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NPI Code Detail

MEDICARE: JAMIE M KALAFATICH DO

MEDICARE: JAMIE M KALAFATICH DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0102202308VA
2207Q00000XFamily Medicine Physician56344MN
3207Q00000XFamily Medicine Physician0116018762VA

General Provider Information

NPI Number : 1972764165
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE M KALAFATICH DO
Provider Business Mailing Address
First Line : 16890 FOREST RD
Second Line :
City : FOREST
State : VA
Zip : 24551-4059
Country : US
Telephone Number : 434-200-7210
Fax Number : 434-525-2138
Provider Business Practice Location Address
First Line : 16890 FOREST RD
Second Line :
City : FOREST
State : VA
Zip : 24551-4059
Country : US
Telephone Number : 434-200-7210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2008
Last Update Date : 07/18/2023

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