MEDICARE: SUCHARITHA VIGNESHWAR MD PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0101226514	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417144379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUCHARITHA VIGNESHWAR MD PLLC

Provider Business Mailing Address
First Line	:	7603 FOREST AVE STE 407
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4944
Country	:	US
Telephone Number	:	804-282-5001
Fax Number	:

Provider Business Practice Location Address
First Line	:	7603 FOREST AVE., SUITE 407
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-1922
Country	:	US
Telephone Number	:	804-282-5001
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. FAYE ROGERS CARROLL
Credential	:
Telephone Number	:	804-282-5001

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	10/01/2010

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