MEDICARE: VAUGHAN HENRY HOWARD JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101028659	VA

General Provider Information

NPI Number	:	1427282094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VAUGHAN HENRY HOWARD JR. M.D.

Provider Business Mailing Address
First Line	:	PO BOX 947
Second Line	:
City	:	WHITE MARSH
State	:	VA
Zip	:	23183-0947
Country	:	US
Telephone Number	:	804-693-4788
Fax Number	:

Provider Business Practice Location Address
First Line	:	6095 INDIAN RIVER RD
Second Line	:	SUITE 201
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-3818
Country	:	US
Telephone Number	:	804-693-4788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2009
Last Update Date	:	05/11/2009

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