Provider Demographics
NPI: | 1407392582 |
---|---|
Name: | DALAWARI MEDICAL SERVICES |
Entity Type: | Organization |
Organization Name: | DALAWARI MEDICAL SERVICES |
Other - Org Name: | DALAWARI CARDIOVASCULAR |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JASDEEP |
Authorized Official - Middle Name: | S |
Authorized Official - Last Name: | DALAWARI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 804-991-4109 |
Mailing Address - Street 1: | 1858 GREY OAKS PARK LN |
Mailing Address - Street 2: | |
Mailing Address - City: | GLEN ALLEN |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23059-5798 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 918-699-9525 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4870 SADLER RD STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | GLEN ALLEN |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23060-6294 |
Practice Address - Country: | US |
Practice Address - Phone: | 804-991-4109 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-01-12 |
Last Update Date: | 2023-08-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Single Specialty |