Doctor Name: | DR. JOHN ROBERT MASCOLA |
NPI Number: | 1083790745 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G59935 |
Business Practice Address: | National Naval Medical Ctr 8901 Rockville Pike Bethesda, MD - 208895600 |
Business Phone Number: | 3012954611 |
Business Fax Number: | |
Mailing Address: | Vaccine Research Center Niaid Nih, 40 Convent Drive, Msc 3015 BETHESDA |
State: | MD |
Postal Code: | 208920001 |
Phone Number: | 3015948487 |
Fax Number: | 3014802788 |
NPI Enumeration Date: | 10/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | G59935 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |