DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. ERIC JIVIDEN, MPAS, PA-C

Active

MR. ERIC JIVIDEN, MPAS, PA-C is a Medical Physician Assistant healthcare provider located in CENTREVILLE, Virginia. NPI 1134507734 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · CENTREVILLE, VA

Registration Details

NPI Number
1134507734
Provider Type
Individual
Gender
Male
NPI Issued
May 14, 2015 (11.223964686414 yrs)
Last Updated
May 15, 2015
Licenses
0110002105 (VA)
103779 (NC)

Practice Information

Address
13700 CRYSTALFORD CT
CENTREVILLE, VA, 201202085
Browse VA providers · Browse ZIP 20120
Phone
7039694190
Primary Specialty
Medical Physician Assistant
363AM0700X
Additional Specialty
Medical Physician Assistant

Other Medical Physician Assistant Providers in CENTREVILLE, VA

Name Credential NPI
GILDA LOGA PA-C 1578669610
STACEY T SHEPHERD PA-C 1679673255
STORY MCDONALD PA-C 1619094158
MISS MICHELLE BURTON PA-C 1245685163
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.