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General NPI Number Information
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NPI Number | 1710904503
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Entity Type | Organization
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Legal Business Name | HEMORRHOID CARE CENTER OF VA, P.C.
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 816 INDEPENDENCE BLVD SUITE 3-K
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-6010
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Country | US
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Telephone | 757-460-0002
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Fax | 757-460-1335
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Provider Business Mailing Address
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Address Line | PO BOX 68397
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City | VIRGINIA BEACH
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State | VA
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Zip | 23471-8397
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Country | US
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Telephone | 757-460-0002
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Fax | 757-460-1335
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RAMESH C. LUTHRA
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Credential | M.D.
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Telephone | 757-460-0002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101020975
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License Number State | VA
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