Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A152933 | CA |
N | 111NI0900X | Internist | A152933 | CA |
N | 207RG0100X | Gastroenterologist | A152933 | CA |
N | 208000000X | Pediatrician | A153432 | CA |
Y | 2080P0206X | Pediatric Gastroenterologist | 35.126742 | OH |
NPI | 1043519309 |
---|---|
Provider Name | David Vitale |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2011 |
Last Update Date | 29/08/2019 |