Provider Demographics
NPI:1801864624
Name:VAVREK, JOHN (NAVY IDC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:VAVREK
Suffix:
Gender:M
Credentials:NAVY IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NNMC BETHESDA, INTERNAL MEDICINE
Mailing Address - Street 2:8901 WISCONSIN AVE
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889
Mailing Address - Country:US
Mailing Address - Phone:301-295-4571
Mailing Address - Fax:301-295-5164
Practice Address - Street 1:NNMC BETHESDA INTERNAL MEDICINE
Practice Address - Street 2:8901 WISCONSIN AVE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-4571
Practice Address - Fax:301-295-5164
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman