Provider Demographics
NPI:1699926527
Name:ANTE, NILDA R (MD)
Entity type:Individual
Prefix:DR
First Name:NILDA
Middle Name:R
Last Name:ANTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NILDA
Other - Middle Name:R
Other - Last Name:ONG ANTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1033 28TH ST
Mailing Address - Street 2:DEPT OF OBGYN
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23607-4233
Mailing Address - Country:US
Mailing Address - Phone:757-591-0643
Mailing Address - Fax:757-952-2577
Practice Address - Street 1:4714 MARSHALL AVE
Practice Address - Street 2:DEPT OF OBGYN
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23607-2247
Practice Address - Country:US
Practice Address - Phone:757-591-0643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101022338207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEE09068Medicare UPIN