Healthcare Provider Details

I. General information

NPI: 1750363396
Provider Name (Legal Business Name): MOHIT NANDA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PETER JEFFERSON PKWY SUITE 350
CHARLOTTESVILLE VA
22911-8608
US

IV. Provider business mailing address

600 PETER JEFFERSON PKWY SUITE 350
CHARLOTTESVILLE VA
22911-8608
US

V. Phone/Fax

Practice location:
  • Phone: 434-978-2040
  • Fax: 434-978-2041
Mailing address:
  • Phone: 434-978-2040
  • Fax: 434-978-2041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number010237265
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number010237265
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: