Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 0101053890 | VA |
NPI | 1033145073 |
---|---|
Provider Name | Raymond Amaker |
First Address | Yorktown, VA 23693-2762 |
Second Address | Newport News, VA 23601-1929 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6728821 | (05) | VA |
G33625 | (02) |