Healthcare Provider Details

I. General information

NPI: 1235366972
Provider Name (Legal Business Name): VAISHALI PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VAISHALI MANSUKHLAL KASUNDRA M.D.

II. Dates (important events)

Enumeration Date: 06/21/2009
Last Update Date: 08/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E BROAD ST DIV OF GASTROENTEROLOGY & HEPATOLOGY,W HOSP, FL 14
RICHMOND VA
23298-5058
US

IV. Provider business mailing address

PO BOX 980341 VCUHS, DIV OF GASTROENEROLOGY, HEPATOLOGY AND NUTRITION
RICHMOND VA
23298-0341
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-4060
  • Fax: 804-828-5348
Mailing address:
  • Phone: 804-828-4060
  • Fax: 804-828-5348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number0101258962
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: