Provider Demographics
NPI:1568401750
Name:BAVA, JOSEPH V (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:V
Last Name:BAVA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 MCCOMAS WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-3908
Mailing Address - Country:US
Mailing Address - Phone:757-301-9996
Mailing Address - Fax:757-301-9958
Practice Address - Street 1:2117 MCCOMAS WAY STE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-3908
Practice Address - Country:US
Practice Address - Phone:757-301-9996
Practice Address - Fax:757-301-9958
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103001037213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9303499Medicaid
VADR4924OtherMEDICARE RAIL ROAD
VAU71614Medicare UPIN
VA6548110001Medicare NSC
VADR4924OtherMEDICARE RAIL ROAD