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General NPI Number Information
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NPI Number | 1417144379
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Entity Type | Organization
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Legal Business Name | SUCHARITHA VIGNESHWAR MD PLLC
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 7603 FOREST AVE., SUITE 407
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City | RICHMOND
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State | VA
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Zip | 23229-1922
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Country | US
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Telephone | 804-282-5001
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Fax |
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Provider Business Mailing Address
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Address Line | 7603 FOREST AVE STE 407
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City | RICHMOND
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State | VA
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Zip | 23229-4944
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Country | US
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Telephone | 804-282-5001
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. FAYE ROGERS CARROLL
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Credential |
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Telephone | 804-282-5001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101226514
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License Number State | VA
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