Provider Demographics
NPI:1487638623
Name:DALTON, JOSEPH M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:DALTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:329 PHILLIP AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4461
Mailing Address - Country:US
Mailing Address - Phone:757-481-2313
Mailing Address - Fax:757-481-5587
Practice Address - Street 1:1020 FIRST COLONIAL RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3002
Practice Address - Country:US
Practice Address - Phone:757-481-2313
Practice Address - Fax:757-481-0569
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2020-03-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101047388208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007307993Medicaid