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General NPI Number Information
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NPI Number | 1194220517
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Entity Type | Individual
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Provider Name | MAYAND PRAFUL VAKIL MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 241 CHARLES H DIMMOCK PKWY STE 6
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2915
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Country | US
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Telephone | 804-765-5320
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Fax | 804-805-2903
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Provider Business Mailing Address
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Address Line | 241 CHARLES H DIMMOCK PKWY STE 6
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2915
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Country | US
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Telephone | 804-765-5320
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Fax | 804-805-2903
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | 0101277151
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License Number State | VA
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