Provider Demographics
NPI:1164753695
Name:VODA, DAVID JOSEF
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSEF
Last Name:VODA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS GUARDIAN MCM-5
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96666-1925
Mailing Address - Country:US
Mailing Address - Phone:315-252-1292
Mailing Address - Fax:
Practice Address - Street 1:USS GUARDIAN MCM-5
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96666-1925
Practice Address - Country:US
Practice Address - Phone:315-252-1292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman