Healthcare Provider Details

I. General information

NPI: 1306856133
Provider Name (Legal Business Name): MADHUKAR KALOJI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 INDEPENDENCE CIR STE 3D
VIRGINIA BEACH VA
23455-6405
US

IV. Provider business mailing address

P.O. BOX 62229
VIRGINIA BEACH VA
23466
US

V. Phone/Fax

Practice location:
  • Phone: 757-460-6080
  • Fax: 757-460-6081
Mailing address:
  • Phone: 757-460-6080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0101840471
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number0101840471
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: