Healthcare Provider Details

I. General information

NPI: 1770993081
Provider Name (Legal Business Name): VIRGINIA RETINA CONSULTANTS, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 LEW DEWITT BLVD SUITE 5
WAYNESBORO VA
22980-1665
US

IV. Provider business mailing address

540 LEW DEWITT BLVD SUITE 5
WAYNESBORO VA
22980-1665
US

V. Phone/Fax

Practice location:
  • Phone: 540-949-9080
  • Fax: 540-949-5758
Mailing address:
  • Phone: 540-949-9080
  • Fax: 540-949-5758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MOHIT NANDA
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 434-978-2040