1558328849 NPI number — VILMA CAMOMOT WITTEN MD, MPH

Table of content: MORGAN SENATH MELVIN NP (NPI 1629791710)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558328849 NPI number — VILMA CAMOMOT WITTEN MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WITTEN
Provider First Name:
VILMA
Provider Middle Name:
CAMOMOT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558328849
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5001 E PATRICK HENRY HWY
Provider Second Line Business Mailing Address:
PIEDMONT GERIATRIC HOSPITAL
Provider Business Mailing Address City Name:
BURKEVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23922-0427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-767-4535
Provider Business Mailing Address Fax Number:
434-767-4404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5001 E PATRICK HENRY HWY
Provider Second Line Business Practice Location Address:
PIEDMONT GERIATRIC HOSPITAL
Provider Business Practice Location Address City Name:
BURKEVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23922-0427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-767-4535
Provider Business Practice Location Address Fax Number:
434-767-4404
Provider Enumeration Date:
04/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  0101035946 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 080160443 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2809573 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 215340 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 289565 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 128618 . This is a "SOUTHERN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4264918 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5610940 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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