Healthcare Provider Details

I. General information

NPI: 1073647483
Provider Name (Legal Business Name): DAVID JOSEPH VIOLA IDC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL OKINAWA JAPAN PSC 482 BOX 1600
FPO AP
AP
US

IV. Provider business mailing address

PSC 557 BOX 2194
FPO AP
AP
US

V. Phone/Fax

Practice location:
  • Phone: 011816117422378
  • Fax:
Mailing address:
  • Phone: 011816117422378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: