Provider Demographics
NPI:1457665846
Name:ADANIEL, VICTOR ROMEO CLEMENTE (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:ROMEO CLEMENTE
Last Name:ADANIEL
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 1:502 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-1222
Mailing Address - Country:US
Mailing Address - Phone:434-392-9438
Mailing Address - Fax:
Practice Address - Street 1:502 BEECH ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-1222
Practice Address - Country:US
Practice Address - Phone:434-392-9438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101263718207R00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine