MEDICARE: MANU R. GADANI, MD PC INC

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	207R00000X	Internal Medicine Physician	0101053054	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110212740	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	010558	OTHER	VA	CIGNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	230297	OTHER	VA	BLUE SHIELD/ANTHEUM

General Provider Information

NPI Number	:	1366530198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANU R. GADANI, MD PC INC

Provider Business Mailing Address
First Line	:	5303 PLAZA DR
Second Line	:	SUITE--101
City	:	HOPEWELL
State	:	VA
Zip	:	23860-7331
Country	:	US
Telephone Number	:	804-458-3629
Fax Number	:

Provider Business Practice Location Address
First Line	:	5303 PLAZA DR
Second Line	:	SUITE--101
City	:	HOPEWELL
State	:	VA
Zip	:	23860-7331
Country	:	US
Telephone Number	:	804-458-3629
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MANU R GADANI
Credential	:	MD
Telephone Number	:	804-458-2006

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/22/2011

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