Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 0101057283 | VA |
NPI | 1083732325 |
---|---|
Provider Name | John L Ditto |
First Address | Richmond, VA 23227-1149 |
Second Address | Colonial Heights, VA 23834-2915 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 05/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1083732325 | (05) | VA |
F79556 | (02) |