MEDICARE: DR. HARLAN L VINGAN MD

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	0101043643	VA
2	2085R0204X	Vascular & Interventional Radiology Physician	0101043643	VA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	300062521	OTHER	VA	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10076448	OTHER	VA	OPTIMA HEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	10076448	OTHER	VA	SENTARA HEALTH
4	15808	OTHER	VA	SENTARA
6	15808	OTHER	VA	OPTIMA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	139178	OTHER	VA	BCBS

NPI Number	:	1982688164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARLAN L VINGAN MD

Provider Business Mailing Address
First Line	:	5544 GREENWICH RD STE 200
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6563
Country	:	US
Telephone Number	:	757-466-0089
Fax Number	:	757-466-8017

Provider Business Practice Location Address
First Line	:	5544 GREENWICH RD STE 200
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6563
Country	:	US
Telephone Number	:	757-466-0089
Fax Number	:	757-466-8017

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	11/21/2023

5544 GREENWICH RD STE 302
VIRGINIA BEACH, VA
23462-6563

Practice Phone: 757-461-0600
Practice Fax: 757-461-0610

5544 GREENWICH RD STE 200
VIRGINIA BEACH, VA
23462-6563