Provider Demographics
NPI:1740640804
Name:VIRGINIA HEMATOLOGY ONCOLOGY PHYSICIANS INC
Entity type:Organization
Organization Name:VIRGINIA HEMATOLOGY ONCOLOGY PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-648-2704
Mailing Address - Street 1:2556 FOX HOUND CT
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2996
Mailing Address - Country:US
Mailing Address - Phone:301-648-2704
Mailing Address - Fax:206-339-7919
Practice Address - Street 1:2556 FOX HOUND CT
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-2996
Practice Address - Country:US
Practice Address - Phone:301-648-2704
Practice Address - Fax:206-339-7919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101259771207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty