Provider Demographics
NPI:1639529456
Name:VALLET, VICTOR JAY (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:JAY
Last Name:VALLET
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:204 W HILL BLVD BLDG 364
Mailing Address - Street 2:
Mailing Address - City:JOINT BASE CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29404-4704
Mailing Address - Country:US
Mailing Address - Phone:843-963-6880
Mailing Address - Fax:843-963-6970
Practice Address - Street 1:204 W HILL BLVD BLDG 364
Practice Address - Street 2:
Practice Address - City:JOINT BASE CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29404-4704
Practice Address - Country:US
Practice Address - Phone:843-963-6880
Practice Address - Fax:843-963-6970
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE7648207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine