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General NPI Number Information
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NPI Number | 1447413885
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Entity Type | Individual
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Provider Name | JOSEPH CORBO MD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 110 PLEASANT ST NW BIRCH C
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City | VIENNA
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State | VA
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Zip | 22180-4308
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Country | US
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Telephone | 703-255-3406
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Fax | 703-255-3409
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Provider Business Mailing Address
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Address Line | 110 PLEASANT ST NW BIRCH C
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City | VIENNA
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State | VA
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Zip | 22180-4308
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Country | US
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Telephone | 703-255-3406
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Fax | 703-255-3409
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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 | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 01010029512
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License Number State | VA
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