Provider Demographics
NPI:1699873760
Name:VAMENTA, RENE NERI (MD)
Entity type:Individual
Prefix:DR
First Name:RENE
Middle Name:NERI
Last Name:VAMENTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:681 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-1750
Mailing Address - Country:US
Mailing Address - Phone:540-483-2849
Mailing Address - Fax:540-483-2826
Practice Address - Street 1:681 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1750
Practice Address - Country:US
Practice Address - Phone:540-483-2849
Practice Address - Fax:540-483-2826
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101049828208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics