Provider Demographics
NPI:1568843944
Name:ORDONEZ, NEMESIO RODRIGO (MD)
Entity Type:Individual
Prefix:
First Name:NEMESIO
Middle Name:RODRIGO
Last Name:ORDONEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NEMESIO
Other - Middle Name:RA
Other - Last Name:ORDONEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:620 JOHN PAUL JONES CIR
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23708-2111
Mailing Address - Country:US
Mailing Address - Phone:757-953-1893
Mailing Address - Fax:757-953-7560
Practice Address - Street 1:620 JOHN PAUL JONES CIR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2111
Practice Address - Country:US
Practice Address - Phone:757-953-1893
Practice Address - Fax:757-953-7560
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
VA01012614322084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No171000000XOther Service ProvidersMilitary Health Care Provider
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD0000Medicare UPIN