MEDICARE: DR. ANANT S DAMLE 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	207RG0100X	Gastroenterology Physician	101221471	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
9	005390G25	OTHER	MEDICARE TRAILBLAZERS
10	C05825	OTHER	MEDICARE GROUP
11	C13214	OTHER	MEDICARE RR GROUP
12	P001437930	OTHER	TRAVELERS RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	142987	OTHER	ANTHEM HBV
4	541870984006	OTHER	CHAMPUS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	20739	OTHER	SENTARA OPTIMA
7	541870984	OTHER	VA HEALTH NETWORK
8	541870984028	OTHER	CIGNA
13	497934	OTHER	MAMSI OPT CHOICE

General Provider Information

NPI Number	:	1831173665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANANT S DAMLE MD

Provider Business Mailing Address
First Line	:	5818 HARBOUR VIEW BLVD
Second Line	:	STE 240
City	:	SUFFOLK
State	:	VA
Zip	:	23435-3315
Country	:	US
Telephone Number	:	757-483-6100
Fax Number	:	757-483-2203

Provider Business Practice Location Address
First Line	:	5818 HARBOUR VIEW BLVD
Second Line	:	STE 240
City	:	SUFFOLK
State	:	VA
Zip	:	23435-3315
Country	:	US
Telephone Number	:	757-483-6100
Fax Number	:	757-483-2203

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

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	06/18/2025

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Directions to “ DR. ANANT S DAMLE MD” Practice Location

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