Healthcare Provider Details

I. General information

NPI: 1700976834
Provider Name (Legal Business Name): VIRGINIA RETINA CONSULTANTS, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PETER JEFFERSON PKWY STE 350
CHARLOTTESVILLE VA
22911-8836
US

IV. Provider business mailing address

600 PETER JEFFERSON PKWY STE 350
CHARLOTTESVILLE VA
22911-8836
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 TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MOHIT NANDA
Title or Position: OWNER
Credential: MD
Phone: 434-978-2040