Provider Demographics
NPI:1669445078
Name:AMABILE, ANTHONY T (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:T
Last Name:AMABILE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3539
Mailing Address - Fax:757-686-0230
Practice Address - Street 1:816 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 1H
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6010
Practice Address - Country:US
Practice Address - Phone:757-464-2013
Practice Address - Fax:757-464-3046
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2010-04-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101046727207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541595397OtherMID ATLANTIC SOLUTIONS
VA006032729Medicaid
VA541595397OtherPRIVATE HEALTHCARE SYSTEM
VA541595397OtherTRICARE
VA541595397OtherCIGNA
VA541595397OtherVIRGINIA HEALTH NETWORK
VA437421OtherANTHEM
VA541595397OtherAETNA
VA10091OtherSENTARA/OPTIMA
VA541595397OtherMID ATLANTIC SOLUTIONS
VA541595397OtherVIRGINIA HEALTH NETWORK