Provider Demographics
NPI:1427282094
Name:HOWARD, VAUGHAN HENRY JR (MD)
Entity type:Individual
Prefix:
First Name:VAUGHAN
Middle Name:HENRY
Last Name:HOWARD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 947
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:VA
Mailing Address - Zip Code:23183-0947
Mailing Address - Country:US
Mailing Address - Phone:804-693-4788
Mailing Address - Fax:
Practice Address - Street 1:6095 INDIAN RIVER RD
Practice Address - Street 2:SUITE 201
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-3818
Practice Address - Country:US
Practice Address - Phone:804-693-4788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101028659207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine