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General NPI Number Information
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NPI Number | 1932924560
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Entity Type | Organization
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Legal Business Name | MOUNTAIN SPRING VASCULAR
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 5589 GREENWICH RD STE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6565
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Country | US
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Telephone | 757-437-2882
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 101
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City | STEVENSON
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State | MD
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Zip | 21153-0101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | SALMAN MUFTI
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Credential | MD
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Telephone | 540-680-3433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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