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General NPI Number Information
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NPI Number | 1740640804
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Entity Type | Organization
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Legal Business Name | VIRGINIA HEMATOLOGY ONCOLOGY PHYSICIANS INC
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 2556 FOX HOUND CT
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City | HERNDON
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State | VA
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Zip | 20171-2996
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Country | US
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Telephone | 301-648-2704
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Fax | 206-339-7919
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Provider Business Mailing Address
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Address Line | 2556 FOX HOUND CT
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City | HERNDON
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State | VA
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Zip | 20171-2996
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Country | US
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Telephone | 301-648-2704
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Fax | 206-339-7919
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MANAN MEHTA
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Credential | M.D.
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Telephone | 301-648-2704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 0101259771
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License Number State | VA
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