Healthcare Provider Details

I. General information

NPI: 1730114083
Provider Name (Legal Business Name): JULIA D'AMORA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 03/07/2023
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 CRYSTAL SPRING AVE SW SUITE 302
ROANOKE VA
24014-2462
US

IV. Provider business mailing address

PO BOX 40032
ROANOKE VA
24022-0032
US

V. Phone/Fax

Practice location:
  • Phone: 540-981-7653
  • Fax: 540-981-7469
Mailing address:
  • Phone: 540-224-5175
  • Fax: 540-985-5329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number02002852A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102-201235
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: