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General NPI Number Information
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NPI Number | 1457539694
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Entity Type | Individual
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Provider Name | SALVATORE GIALLOMBARDO III IDC
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Gender | Male
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 08/19/2011
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Provider Practice Location Address
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Address Line | 581 A ST BLDG 312 MSFSC
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City | NORFOLK
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State | VA
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Zip | 23511-4004
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Country | US
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Telephone | 757-443-3194
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Fax | 757-443-2364
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Provider Business Mailing Address
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Address Line | 5256 CHIPPING LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-6801
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Country | US
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Telephone | 904-507-9403
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Fax | 757-961-7240
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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 | 1710I1002X
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Taxonomy Name | Independent Duty Corpsman
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License Number |
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License Number State |
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