MEDICARE: DR. GUNADHAR PANIGRAHI MD

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	207RC0000X	Cardiovascular Disease Physician	0101035440	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	269854	OTHER	VA	ANTHEM
2	PAR	OTHER	VA	VIRGINIA HEALTH NETWORK
3	-001	OTHER	VA	TRICARE/CHAMPUS
4	10015734	OTHER	VA	SENTARA OPTIMA
5	12375	OTHER	VA	OPTIMA HEALTH PLAN
6	PAR	OTHER	VA	AETNA
7	PAR	OTHER	VA	USA MANAGED CARE
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	PAR	OTHER	VA	CIGNA
10	PAR	OTHER	VA	MULTIPLAN
11	06381	OTHER	NC	BC/BS
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	187094	OTHER	VA	ANTHEM BC/BS
14	413774	OTHER		UHC/MAMSI
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	313774	OTHER	VA	MAMSI
17	PAR	OTHER	VA	CORVEL/CORCARE
18	PAR	OTHER	VA	FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
19	PAR	OTHER	VA	VIRGINIA PREMIER HEALTH

General Provider Information

NPI Number	:	1467488106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GUNADHAR PANIGRAHI MD

Provider Business Mailing Address
First Line	:	205 BUSINESS PARK DR
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6335
Country	:	US
Telephone Number	:	757-962-1083
Fax Number	:	757-962-1254

Provider Business Practice Location Address
First Line	:	1925 GLENN MITCHELL DR
Second Line	:	SUITE 202
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-0170
Country	:	US
Telephone Number	:	757-507-0702
Fax Number	:	757-962-1254

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	08/12/2011

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Directions to “ DR. GUNADHAR PANIGRAHI MD” Practice Location

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