MEDICARE: CENTER FOR HEART AND VASCULAR STUDIES 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
1	207RC0000X	Cardiovascular Disease Physician	0101036492	VA

General Provider Information

NPI Number	:	1699717116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR HEART AND VASCULAR STUDIES LLC

Provider Business Mailing Address
First Line	:	PO BOX 2546
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23450-2546
Country	:	US
Telephone Number	:	757-340-3489
Fax Number	:	757-340-4278

Provider Business Practice Location Address
First Line	:	1531 AMBERLEY FOREST RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-4706
Country	:	US
Telephone Number	:	757-340-3489
Fax Number	:	757-340-4278

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. RONALD E MODLINGER
Credential	:	MD
Telephone Number	:	757-471-3838

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	08/22/2020

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