MEDICARE: RAVINDER MOHAN 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	207Q00000X	Family Medicine Physician	0101059248	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1992771521	OTHER	VA	AETNA
3	1992771521	OTHER	VA	UNITED HEALTHCARE
4	PAR	OTHER	VA	MULTIPLAN
5	PAR	OTHER	VA	VIRGINIA HEALTH NETWORK
6	PAR	OTHER	VA	CORVEL/CORCARE
7	-002 -003	OTHER	VA	TRICARE/CHAMPUS
8	1992771521	OTHER	VA	ANTHEM BC/BS
9	PAR	OTHER	VA	CIGNA
10	PAR	OTHER	VA	USA MANAGED CARE
11	1992771521	OTHER	VA	OPTIMA HEALTH
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	1992771521	OTHER	VA	VIRGINIA PREMIER HEALTH PLAN
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992771521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAVINDER MOHAN MD

Provider Business Mailing Address
First Line	:	5320 PROVIDENCE RD
Second Line	:	SUITE 301
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-4122
Country	:	US
Telephone Number	:	757-413-7600
Fax Number	:	757-507-9051

Provider Business Practice Location Address
First Line	:	5320 PROVIDENCE RD
Second Line	:	SUITE 301
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-4122
Country	:	US
Telephone Number	:	757-413-7600
Fax Number	:	757-507-9051

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

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	09/10/2018

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Directions to “ RAVINDER MOHAN MD” Practice Location

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