Provider Demographics
NPI:1649891326
Name:VARVA, JOSEPH JOHN III
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:JOHN
Last Name:VARVA
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7017 BRUIN CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20111-4374
Mailing Address - Country:US
Mailing Address - Phone:844-438-7228
Mailing Address - Fax:
Practice Address - Street 1:7017 BRUIN CT
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20111-4374
Practice Address - Country:US
Practice Address - Phone:844-438-7228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAA61302276172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver