Provider Demographics
NPI:1972569598
Name:VUOLO, ANTHONY J JR (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:VUOLO
Suffix:JR
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 1:1547 AMBERLEY FOREST RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-4706
Mailing Address - Country:US
Mailing Address - Phone:757-963-6363
Mailing Address - Fax:757-963-0262
Practice Address - Street 1:1547 AMBERLEY FOREST RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-4706
Practice Address - Country:US
Practice Address - Phone:757-963-6363
Practice Address - Fax:757-963-0262
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002140L213E00000X
VA0103300951213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08789OtherMEDICARE
VA1026024Medicaid
VA1026024Medicaid
VAC08789OtherMEDICARE