MEDICARE: DR. ONAN WALKER BOMAR IV M.D.

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	0101255432	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	VAD000	OTHER	TN	FEDERAL UPIN

General Provider Information

NPI Number	:	1740445543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ONAN WALKER BOMAR IV M.D.

Provider Business Mailing Address
First Line	:	1395 NW 167TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-5710
Country	:	US
Telephone Number	:	804-228-1143
Fax Number	:

Provider Business Practice Location Address
First Line	:	3806 MECHANICSVILLE TPKE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-1114
Country	:	US
Telephone Number	:	804-228-1143
Fax Number	:

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

Provider Enumeration Date	:	07/22/2008
Last Update Date	:	06/23/2021

Similar Medicare Providers

1912561564 — SASHA-KAY ALICIA D'AGUILAR MD
Practice Location Address:

3806 MECHANICSVILLE TPKE
RICHMOND, VA
23223-1114

Practice Phone: 804-228-1143
Practice Fax: 804-554-5386

1841277977 — PAIGE R RACKLIFFE MD
Practice Location Address:

3806 MECHANICSVILLE TPKE
RICHMOND, VA
23223-1114

Practice Phone: 804-228-1143
Practice Fax: 804-228-7382

1477630374 — DR. ASHLEY NICHOLS
Practice Location Address:

3824 MECHANICSVILLE PIKE , UNIT #12
RICHMOND, VA
23223-1114

Practice Phone: 804-321-3023
Practice Fax:

1578694311 — DR. SADAF AHMED DDS
Practice Location Address:

3824 MECHANICSVILLE PIKE , UNIT 12
RICHMOND, VA
23223-1114

Practice Phone: 804-321-5665
Practice Fax:

1285836353 — DR. MAURICIO RICARDO MONRROY PRADO M.D.
Practice Location Address:

3806 MECHANICSVILLE TPKE
RICHMOND, VA
23223-1114

Practice Phone: 804-228-1143
Practice Fax:

1477757243 — DR. ANTHONY DARNELL JONES M.D.
Practice Location Address:

3808 MECHANICSVILLE TPKE
RICHMOND, VA
23223-1114

Practice Phone: 804-228-1143
Practice Fax: 804-228-7382

Directions to “ DR. ONAN WALKER BOMAR IV M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.