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Contact Information

KEVIN R DMYTRIW, MD
524 SOUTHPARK BOULEVARD
JENCARE NEIGHBORHOOD MEDICAL SOUTH PARK, LLC
COLONIAL HEIGHTS, VA23834
 Phone: 804-504-7980
 Fax: 804-504-7991
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for KEVIN R DMYTRIW · (Male)

NPI # 1598768038
Status Active
Credentials MD
Entity Individual
Enumeration date 05/28/2005
Last updated 08/14/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # 33539
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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