Healthcare Provider Details

I. General information

NPI: 1427016526
Provider Name (Legal Business Name): SUCHARITHA VIGNESHWAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 BREMO RD STE 206
RICHMOND VA
23226
US

IV. Provider business mailing address

5855 BREMO RD STE 206
RICHMOND VA
23226
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-5001
  • Fax: 804-282-5008
Mailing address:
  • Phone: 804-282-5001
  • Fax: 804-282-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101226514
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35070649V
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: