Provider Demographics
NPI:1447234844
Name:KAMGUIA, PIERRE (MD)
Entity Type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:
Last Name:KAMGUIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5814 OAK KNOLL RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2402
Mailing Address - Country:US
Mailing Address - Phone:276-226-1017
Mailing Address - Fax:
Practice Address - Street 1:2401 SHEILA LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-2039
Practice Address - Country:US
Practice Address - Phone:804-245-3679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101543591207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E60571Medicare UPIN