Provider Demographics
NPI:1336316231
Name:NAKAMOTO, RONA KEIKO (MD)
Entity Type:Individual
Prefix:DR
First Name:RONA
Middle Name:KEIKO
Last Name:NAKAMOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 CRABBERS COVE LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4610
Mailing Address - Country:US
Mailing Address - Phone:757-373-1539
Mailing Address - Fax:757-631-9571
Practice Address - Street 1:2100 STEPPINGSTONE SQ
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2517
Practice Address - Country:US
Practice Address - Phone:757-424-8227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-11
Last Update Date:2008-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051953207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010232805Medicaid
MDC82264Medicare UPIN