MEDICARE: DR. ARVIND Z VIRADIA MD

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	207R00000X	Internal Medicine Physician	15105	WV

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	:	1417947904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARVIND Z VIRADIA MD

Provider Business Mailing Address
First Line	:	117 GOFF MOUNTAIN RD
Second Line	:
City	:	CROSS LANES
State	:	WV
Zip	:	25313-1434
Country	:	US
Telephone Number	:	304-776-2072
Fax Number	:	304-776-7678

Provider Business Practice Location Address
First Line	:	117 GOFF MOUNTAIN RD
Second Line	:
City	:	CROSS LANES
State	:	WV
Zip	:	25313-1434
Country	:	US
Telephone Number	:	304-776-2072
Fax Number	:	304-776-7678

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	12/04/2009

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