Provider Demographics
NPI:1922000132
Name:PURVEZ, AKHTAR (MD)
Entity Type:Individual
Prefix:DR
First Name:AKHTAR
Middle Name:
Last Name:PURVEZ
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 1:2335 SEMINOLE LN STE 500
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-8304
Mailing Address - Country:US
Mailing Address - Phone:434-328-2774
Mailing Address - Fax:434-328-2776
Practice Address - Street 1:2335 SEMINOLE LN STE 500
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-8304
Practice Address - Country:US
Practice Address - Phone:434-328-2774
Practice Address - Fax:434-328-2776
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232914208VP0014X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
203639329OtherTRICARE PROVIDER NUMBER
203639329OtherUNITED HEALTHCARE PROVIDE
010216192OtherVA PREMIER PROVIDER NUMBE
58228OtherSENTARA/OPTIMA PROVIDER N
203639329OtherPCHP PROVIDER NUMBER
1442396001OtherCIGNA PROVIDER NUMBER
186276OtherANTHEM PROVIDER NUMBER
VA010216192Medicaid
329086OtherSOUTHERN HEALTH PROVIDER
VAH76673Medicare UPIN
P00304104Medicare PIN
203639329OtherUNITED HEALTHCARE PROVIDE