Healthcare Provider Details

I. General information

NPI: 1043476815
Provider Name (Legal Business Name): NAMIT MAHAJAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 N PARHAM RD STE 315
RICHMOND VA
23294-4424
US

IV. Provider business mailing address

2810 N PARHAM RD STE 315
RICHMOND VA
23294-4424
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-8327
  • Fax: 804-282-3744
Mailing address:
  • Phone: 804-288-8327
  • Fax: 804-282-3744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101253963
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number0101253963
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: