MEDICARE: CARDIOVASCULAR HEALTH 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	207RC0000X	Cardiovascular Disease Physician	0101232846	VA

General Provider Information

NPI Number	:	1568599652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOVASCULAR HEALTH PLLC

Provider Business Mailing Address
First Line	:	117 BULIFANTS BLVD
Second Line	:	SUITE B
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-5712
Country	:	US
Telephone Number	:	757-259-9540
Fax Number	:	757-259-9547

Provider Business Practice Location Address
First Line	:	117 BULIFANTS BLVD
Second Line	:	SUITE B
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-5712
Country	:	US
Telephone Number	:	757-259-9540
Fax Number	:	757-259-9547

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VASUDEV G. ANANTHRAM
Credential	:	MD
Telephone Number	:	757-259-9540

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	02/27/2008

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