Provider Demographics
NPI:1487858916
Name:SANGHAVI, PREMAL C (MD)
Entity Type:Individual
Prefix:DR
First Name:PREMAL
Middle Name:C
Last Name:SANGHAVI
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Gender:F
Credentials:MD
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Mailing Address - Street 1:125 OLDE GREENWICH DR
Mailing Address - Street 2:SUITE 160
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-4001
Mailing Address - Country:US
Mailing Address - Phone:540-741-0544
Mailing Address - Fax:540-741-0546
Practice Address - Street 1:125 HOSPITAL CENTER BLVD
Practice Address - Street 2:SUITE 125
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-6202
Practice Address - Country:US
Practice Address - Phone:540-741-7933
Practice Address - Fax:540-741-7934
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2012-07-26
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Provider Licenses
StateLicense IDTaxonomies
VA0101252518208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery