Provider Demographics
NPI:1760575567
Name:NERI, ANTHONY ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ROBERT
Last Name:NERI
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 1:115 QUAIL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664-4027
Mailing Address - Country:US
Mailing Address - Phone:540-459-5025
Mailing Address - Fax:
Practice Address - Street 1:1065 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1041
Practice Address - Country:US
Practice Address - Phone:540-459-3435
Practice Address - Fax:540-459-3536
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101228201208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006736203Medicaid
VA183897OtherANTHEM- STRASBURG
VA010203244Medicaid
VA292394OtherANTHEM- WOODSTOCK
020620218OtherTAX ID #
VA010203244Medicaid