Provider Demographics
NPI:1144304916
Name:DOUGLAS M RAMPONA MD PC
Entity type:Organization
Organization Name:DOUGLAS M RAMPONA MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:MERCER
Authorized Official - Last Name:RAMPONA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-428-1005
Mailing Address - Street 1:848 FIRST COLONIAL RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6126
Mailing Address - Country:US
Mailing Address - Phone:757-428-1005
Mailing Address - Fax:757-428-0514
Practice Address - Street 1:848 FIRST COLONIAL RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6126
Practice Address - Country:US
Practice Address - Phone:757-428-1005
Practice Address - Fax:757-428-0514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09782Medicare PIN
VAD07756Medicare PIN
VAC09782Medicare ID - Type Unspecified
VA4847010001Medicare NSC