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General NPI Number Information
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NPI Number | 1043519309
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Entity Type | Individual
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Provider Name | DAVID VITALE
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Gender | Male
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Dates
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Enumeration Date | 03/24/2011
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 3333 BURNET AVE DEPARTMENT OF GASTROENTEROLOGY
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City | CINCINNATI
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State | OH
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Zip | 45229
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Country | US
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Telephone | 513-636-8245
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVE ML 2010
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-636-4415
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Fax | 513-636-7805
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A152933
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A152933
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A153432
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 35.126742
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License Number State | OH
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