Provider Demographics
NPI:1447258033
Name:CAMPANA, RICHARD ANTHONY SR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANTHONY
Last Name:CAMPANA
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 SECOND ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-4528
Mailing Address - Country:US
Mailing Address - Phone:757-229-4141
Mailing Address - Fax:757-229-1792
Practice Address - Street 1:312 2ND ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-4528
Practice Address - Country:US
Practice Address - Phone:757-229-4141
Practice Address - Fax:757-229-1792
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2014-05-19
Deactivation Date:2006-03-15
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
VA0101035546207Q00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0603310001OtherDMERC GROUP NUMBER
VA016670OtherANTHEM PROVIDER NUMBER
VA010000206Medicare ID - Type UnspecifiedMEDICARE INDIVIUDAL PROVI
VA0603310001OtherDMERC GROUP NUMBER