Healthcare Provider Details

I. General information

NPI: 1518556950
Provider Name (Legal Business Name): UNIVERSITY VASCULAR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2021
Last Update Date: 11/16/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MEMORIAL DR STE C
DANVILLE VA
27518-2454
US

IV. Provider business mailing address

2054 KILDAIRE FARM RD # 229
CARY NC
27518-6614
US

V. Phone/Fax

Practice location:
  • Phone: 434-528-1909
  • Fax: 276-632-7555
Mailing address:
  • Phone: 434-528-1909
  • Fax: 276-632-7555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SREEJIT NAIR
Title or Position: OWNER
Credential: MD
Phone: 434-528-1909