Provider Demographics
NPI:1730127721
Name:DENSMORE, JEANNE M (MD)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:M
Last Name:DENSMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1562 INSURANCE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-7229
Mailing Address - Country:US
Mailing Address - Phone:434-293-5548
Mailing Address - Fax:434-293-4664
Practice Address - Street 1:1562 INSURANCE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-7229
Practice Address - Country:US
Practice Address - Phone:434-293-5548
Practice Address - Fax:434-293-4664
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053711207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA45315OtherCOMMUNITY HEALTH
VA142771OtherSOUTHERN HEALTH
VA230700OtherANTHEM SVC/HEALTHKEEPERS
VA700001548OtherCIGNA
VA267068OtherMAMSI
VA110124636Medicare PIN
VA230700OtherANTHEM SVC/HEALTHKEEPERS
VA142771OtherSOUTHERN HEALTH
VA267068OtherMAMSI