Provider Demographics
NPI:1356005243
Name:VIRAG
Entity Type:Organization
Organization Name:VIRAG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SAUMIIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALCUTTAWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-688-7050
Mailing Address - Street 1:1001 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1433
Mailing Address - Country:US
Mailing Address - Phone:317-688-7050
Mailing Address - Fax:317-575-1094
Practice Address - Street 1:1001 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1433
Practice Address - Country:US
Practice Address - Phone:317-688-7050
Practice Address - Fax:317-575-1094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty