Provider Demographics
NPI:1891865622
Name:CARDIOVASCULAR ASSOCIATES OF CHARLOTTESVILLE, PLC
Entity Type:Organization
Organization Name:CARDIOVASCULAR ASSOCIATES OF CHARLOTTESVILLE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-293-4072
Mailing Address - Street 1:650 PETER JEFFERSON PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8844
Mailing Address - Country:US
Mailing Address - Phone:434-293-4072
Mailing Address - Fax:434-293-4265
Practice Address - Street 1:650 PETER JEFFERSON PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8844
Practice Address - Country:US
Practice Address - Phone:434-293-4072
Practice Address - Fax:434-293-4265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1891865622Medicaid
VADF6441OtherRAILROAD MEDICARE
VADF6441OtherRAILROAD MEDICARE