Jamielou Custodio Breckenridge, MD | |
9300 Dewitt Loop, Fort Belvoir, VA 22060-5285 | |
(571) 231-3224 | |
Not Available |
Full Name | Jamielou Custodio Breckenridge |
---|---|
Gender | Female |
Speciality | Surgery |
Location | 9300 Dewitt Loop, Fort Belvoir, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679010896 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 0101276676 (Virginia) | Primary |
Entity Name | Winchester Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679711261 PECOS PAC ID: 0244134021 Enrollment ID: O20031124000061 |
Entity Name | Valley Physician Enterprise Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538316203 PECOS PAC ID: 9931268091 Enrollment ID: O20081104000278 |
Mailing Address | Practice Location Address |
---|---|
Jamielou Custodio Breckenridge, MD 9300 Dewitt Loop, Fort Belvoir, VA 22060-5285 Ph: (571) 231-3224 | Jamielou Custodio Breckenridge, MD 9300 Dewitt Loop, Fort Belvoir, VA 22060-5285 Ph: (571) 231-3224 |
Dr. Earl Hahn Lee, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 9300 Dewitt Loop, Fbch, Department Of General Surgery, Fort Belvoir, VA 22060 Phone: 571-231-2556 | |
Dr. Michael Rennel Dunham, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 9501 Farrell Rd, Fort Belvoir, VA 22060 Phone: 703-805-0599 | |
Dr. Jennifer L Viera, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 9300 Dewitt Loop, Fort Belvoir, VA 22060 Phone: 571-231-2556 | |
Dr. Maridelle Millendez Charit, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 9300 Dewitt Loop, Fort Belvoir, VA 22060 Phone: 571-231-2556 | |
Dr. Joseph Stuart Lee, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 9300 Dewitt Loop, Fort Belvoir, VA 22060 Phone: 818-415-5468 | |
Dr. Khristina Hoover Mccoy, MD Surgery Medicare: Medicare Enrolled Practice Location: 9300 Dewitt Loop, Fort Belvoir, VA 22060 Phone: 571-231-2556 |