Provider Demographics
NPI:1821272576
Name:IQBAL O'MEARA, ALIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALIA
Middle Name:M
Last Name:IQBAL O'MEARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALIA MARIE
Other - Middle Name:IQBAL
Other - Last Name:DENNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-9734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:PEDIATRICS
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-828-4080
Practice Address - Fax:804-628-2138
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-003202080P0203X
VA01012330102080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH84804Medicare UPIN