Provider Demographics
NPI:1649233131
Name:SATO, NAOMI (DO)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:SATO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:757-810-5029
Mailing Address - Fax:757-953-7560
Practice Address - Street 1:620 JOHN PAUL JONES CIR APT D
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:757-810-5029
Practice Address - Fax:757-953-7560
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2024-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102036983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080143392OtherRAILROAD MEDICARE
VA5634271Medicaid
NC790621NMedicaid
VA5634271Medicaid
NC790621NMedicaid