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General NPI Number Information
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NPI Number | 1083598478
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Entity Type | Organization
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Legal Business Name | CENTER FOR VEIN RESTORATION MD LLC
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 1800 CAMELOT DR STE 400
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-2440
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Country | US
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Telephone | 855-830-8346
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Fax |
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Provider Business Mailing Address
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Address Line | 7474 GREENWAY CENTER DR
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City | GREENBELT
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State | MD
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Zip | 20770-3504
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Country | US
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Telephone | 240-965-3261
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SANJIV LAKHANPAL
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Credential |
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Telephone | 240-965-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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