MEDICARE: ROQUE F PLANAS-GALLIANO 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	0101029861	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	32995	OTHER	VA	SENTARA/OPTIMA INSURANCE
2	541951145004	OTHER	VA	TRICARE
3	284087	OTHER	VA	ANTHEM INSURANCE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	541951145	OTHER	VA	CIGNA

General Provider Information

NPI Number	:	1477526853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROQUE F PLANAS-GALLIANO MD

Provider Business Mailing Address
First Line	:	PO BOX 7068
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23707-0068
Country	:	US
Telephone Number	:	757-686-3516
Fax Number	:	757-686-0230

Provider Business Practice Location Address
First Line	:	301 RIVERVIEW AVE
Second Line	:	STE 500
City	:	NORFOLK
State	:	VA
Zip	:	23510-1065
Country	:	US
Telephone Number	:	757-233-8252
Fax Number	:	757-233-8905

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	12/06/2016

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Directions to “ ROQUE F PLANAS-GALLIANO MD” Practice Location

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