Provider Demographics
NPI:1477532315
Name:AUSTIN, RAMONA (MD)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:
Last Name:AUSTIN
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 1:8575 IVOR RD
Mailing Address - Street 2:
Mailing Address - City:IVOR
Mailing Address - State:VA
Mailing Address - Zip Code:23866-3108
Mailing Address - Country:US
Mailing Address - Phone:757-859-6161
Mailing Address - Fax:757-859-6452
Practice Address - Street 1:8575 IVOR RD
Practice Address - Street 2:
Practice Address - City:IVOR
Practice Address - State:VA
Practice Address - Zip Code:23866-3108
Practice Address - Country:US
Practice Address - Phone:757-859-6161
Practice Address - Fax:757-859-6452
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054338207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G52954Medicare UPIN
VA005710H76Medicare PIN