MEDICARE: DR. RAMON A MATAWARAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	0101039962	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467427773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMON A MATAWARAN MD

Provider Business Mailing Address
First Line	:	1232 PERIMETER PKWY STE 206
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-5924
Country	:	US
Telephone Number	:	757-975-4695
Fax Number	:	757-852-0699

Provider Business Practice Location Address
First Line	:	171 KEMPSVILLE RD BLDG A
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-4700
Country	:	US
Telephone Number	:	757-975-4695
Fax Number	:	757-852-0699

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	01/15/2025

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