MEDICARE: DR. RALPH MICHAEL AMEDEO 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		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	:	1558369991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RALPH MICHAEL AMEDEO MD

Provider Business Mailing Address
First Line	:	1715 N GEORGE MASON DR
Second Line	:	SUITE 306
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3609
Country	:	US
Telephone Number	:	703-276-0630
Fax Number	:	703-527-5241

Provider Business Practice Location Address
First Line	:	1715 N GEORGE MASON DR
Second Line	:	SUITE 306
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3609
Country	:	US
Telephone Number	:	703-276-0630
Fax Number	:	703-527-5241

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	07/08/2007

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