1558456491 NPI number — DANIEL JOSEPH VUJNOVICH PHD

Table of content: DR. JOSEPH KIM PHARM.D (NPI 1356774145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558456491 NPI number — DANIEL JOSEPH VUJNOVICH PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VUJNOVICH
Provider First Name:
DANIEL
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558456491
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/11/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1810
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GULFPORT
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39502-1810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
228-338-6606
Provider Business Mailing Address Fax Number:
228-338-6627

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1340 BROAD AVE
Provider Second Line Business Practice Location Address:
SUITE 450
Provider Business Practice Location Address City Name:
GULFPORT
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39501-2404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
228-867-5006
Provider Business Practice Location Address Fax Number:
228-867-5079
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  394 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103T00000X , with the licence number: 1014 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com