MEDICARE: VIRGINIA HEART GROUP, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist		VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356463442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRGINIA HEART GROUP, LTD

Provider Business Mailing Address
First Line	:	13034 RIVERS BEND RD
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23836-2564
Country	:	US
Telephone Number	:	804-530-5178
Fax Number	:	804-530-5185

Provider Business Practice Location Address
First Line	:	13034 RIVERS BEND RD
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23836-2564
Country	:	US
Telephone Number	:	804-530-5178
Fax Number	:	804-530-5185

Authorized Official
Title or Position	:	PRESIDENT, MEDICAL DIRECTOR
Name	:	DR. PHILLIP B DUNCAN
Credential	:	M.D.
Telephone Number	:	804-530-5178

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	08/22/2020

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