Healthcare Provider Details

I. General information

NPI: 1740274836
Provider Name (Legal Business Name): VIPOOL KIRIT GORADIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10431 PATTERSON AVE # C-25
RICHMOND VA
23238-5101
US

IV. Provider business mailing address

14241 MIDLOTHIAN TPKE # 211
MIDLOTHIAN VA
23113-6500
US

V. Phone/Fax

Practice location:
  • Phone: 804-419-4119
  • Fax:
Mailing address:
  • Phone: 804-419-4119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number010105923
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: