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General NPI Number Information
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NPI Number | 1699873760
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Entity Type | Individual
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Provider Name | RENE NERI VAMENTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 681 S MAIN ST
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City | ROCKY MOUNT
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State | VA
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Zip | 24151-1750
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Country | US
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Telephone | 540-483-2849
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Fax | 540-483-2826
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Provider Business Mailing Address
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Address Line | 681 S MAIN ST
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City | ROCKY MOUNT
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State | VA
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Zip | 24151-1750
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Country | US
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Telephone | 540-483-2849
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Fax | 540-483-2826
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101049828
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License Number State | VA
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