Provider Demographics
NPI:1922204163
Name:BOZAK, DAVID JOSEPH (COHC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOSEPH
Last Name:BOZAK
Suffix:
Gender:M
Credentials:COHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 POLARIS ST BLDG 586
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23461-1935
Mailing Address - Country:US
Mailing Address - Phone:757-862-0071
Mailing Address - Fax:757-862-0082
Practice Address - Street 1:472 POLARIS ST BLDG 586
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23461-1935
Practice Address - Country:US
Practice Address - Phone:757-862-0071
Practice Address - Fax:757-862-0082
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
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