Provider Demographics
NPI:1023415825
Name:ALEXANDER T AUGUSTA MED CTR-FT BELVOIR
Entity type:Organization
Organization Name:ALEXANDER T AUGUSTA MED CTR-FT BELVOIR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:STAFF PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMOGIPURAPU
Authorized Official - Middle Name:LAKSHMI
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-231-1345
Mailing Address - Street 1:9300 DEWITT LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-5285
Mailing Address - Country:US
Mailing Address - Phone:703-441-7690
Mailing Address - Fax:703-441-7575
Practice Address - Street 1:3700 FETTLER PARK DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-2050
Practice Address - Country:US
Practice Address - Phone:703-441-7690
Practice Address - Fax:703-441-7575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALEXANDER T AUGUSTA MED CTR-FT BELVOIR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-24
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2148923OtherPK