Provider Demographics
NPI:1700976834
Name:VIRGINIA RETINA CONSULTANTS, PLC
Entity Type:Organization
Organization Name:VIRGINIA RETINA CONSULTANTS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHIT
Authorized Official - Middle Name:
Authorized Official - Last Name:NANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-978-2040
Mailing Address - Street 1:600 PETER JEFFERSON PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8836
Mailing Address - Country:US
Mailing Address - Phone:434-978-2040
Mailing Address - Fax:434-978-2041
Practice Address - Street 1:600 PETER JEFFERSON PKWY STE 350
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8836
Practice Address - Country:US
Practice Address - Phone:434-978-2040
Practice Address - Fax:434-978-2041
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTICELLO COMMUNITY SURGERY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-12
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACIGNAOther2754745
VA173380OtherANTHEM HEALTHKEEPERS
VA4330496OtherAETNA US HEALTHCARE
VA2131855OtherMAMSI LIFE AND HEALTH
VA010281741Medicaid
VA93192OtherOPTIMA HEALTH
VA173380OtherANTHEM
256528OtherSOUTHERN HEALTH SERVICES
VA2131855OtherMAMSI LIFE AND HEALTH
VA4330496OtherAETNA US HEALTHCARE
VA4330496OtherAETNA US HEALTHCARE
VA2131855OtherMAMSI LIFE AND HEALTH