Provider Demographics
NPI:1578592671
Name:KASIRAJAN, VIGNESHWAR (MD)
Entity Type:Individual
Prefix:DR
First Name:VIGNESHWAR
Middle Name:
Last Name:KASIRAJAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E BROAD ST
Mailing Address - Street 2:WEST HOSPITAL 7TH FLOOR
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-5058
Mailing Address - Country:US
Mailing Address - Phone:804-828-4620
Mailing Address - Fax:804-827-0527
Practice Address - Street 1:1200 E BROAD ST
Practice Address - Street 2:WEST HOSPITAL 7TH FLOOR
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5058
Practice Address - Country:US
Practice Address - Phone:804-828-4620
Practice Address - Fax:804-827-0527
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101226618208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7301791Medicaid
VAH22955Medicare UPIN