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NPI Code Detail

MEDICARE: JAMES RIVER CARDIOLOGY, LLC

MEDICARE: JAMES RIVER CARDIOLOGY, LLC
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
1207RC0000XCardiovascular Disease Physician0101241485VA
2207RC0001XClinical Cardiac Electrophysiology Physician
3207RI0011XInterventional Cardiology Physician
4207RC0000XCardiovascular Disease Physician

General Provider Information

NPI Number : 1407157647
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMES RIVER CARDIOLOGY, LLC
Provider Business Mailing Address
First Line : 445 CHARLES DIMMOCK PARKWAY
Second Line : SUITE 100
City : COLONIAL HEIGHTS
State : VA
Zip : 23834
Country : US
Telephone Number : 804-520-1764
Fax Number : 866-781-3220
Provider Business Practice Location Address
First Line : 445 CHARLES H DIMMOCK PKWY STE 100
Second Line :
City : COLONIAL HEIGHTS
State : VA
Zip : 23834-2990
Country : US
Telephone Number : 804-520-1764
Fax Number : 866-781-3220
Authorized Official
Title or Position : CARDIOLOGIST
Name : MITESH S AMIN
Credential : M.D.
Telephone Number : 804-400-1322
Provider Enumeration Date : 11/04/2010
Last Update Date : 08/11/2025

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