Provider Demographics
NPI:1558328849
Name:WITTEN, VILMA CAMOMOT (MD, MPH)
Entity type:Individual
Prefix:
First Name:VILMA
Middle Name:CAMOMOT
Last Name:WITTEN
Suffix:
Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:5001 E PATRICK HENRY HWY
Mailing Address - Street 2:PIEDMONT GERIATRIC HOSPITAL
Mailing Address - City:BURKEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23922-0427
Mailing Address - Country:US
Mailing Address - Phone:434-767-4535
Mailing Address - Fax:434-767-4404
Practice Address - Street 1:5001 E PATRICK HENRY HWY
Practice Address - Street 2:PIEDMONT GERIATRIC HOSPITAL
Practice Address - City:BURKEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23922-0427
Practice Address - Country:US
Practice Address - Phone:434-767-4535
Practice Address - Fax:434-767-4404
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2010-09-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101035946207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080160443OtherRR MEDICARE
2809573OtherAETNA HMO
VA215340OtherANTHEM
289565OtherMAMSI
128618OtherSOUTHERN HEALTH
4264918OtherAETNA
VA5610940Medicaid
080160443OtherRR MEDICARE
080007373Medicare ID - Type Unspecified