Provider Demographics
NPI:1932336203
Name:EBERTOWSKI, JAMES SYLVESTER II (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SYLVESTER
Last Name:EBERTOWSKI
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:860 OMNI BLVD STE 128
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4483
Mailing Address - Country:US
Mailing Address - Phone:757-964-8739
Mailing Address - Fax:
Practice Address - Street 1:5424 DISCOVERY BLVD, BLDG B, STE 203
Practice Address - Street 2:
Practice Address - City:WILLAMSBURGH
Practice Address - State:VA
Practice Address - Zip Code:23188
Practice Address - Country:US
Practice Address - Phone:757-345-6223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101248205208800000X
GA75616208800000X
CO0061398208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology