Search › Maryland › 103G00000X
Johnathan Vital, PH.D
NPI 1477810067 · on the registry since 2012 · sole proprietor
Practice
- Address
- 2413 Altenburg Ct
Waldorf, MD 20603 - Phone
- (301) 653-8828
- Fax
- (202) 558-7113
Registry record
- Primary taxonomy
- 103G00000X
103G00000X
- Also registered as
- 103T00000X
103G00000X
103T00000X - Licence states on file
- MD, DC
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-04-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maryland