Provider Demographics
NPI:1811245970
Name:GANDHI, VIRAL GIRISHCHANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:VIRAL
Middle Name:GIRISHCHANDRA
Last Name:GANDHI
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 1:500 WALTER ST NE STE 501
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2521
Mailing Address - Country:US
Mailing Address - Phone:505-727-3170
Mailing Address - Fax:
Practice Address - Street 1:500 WALTER ST NE STE 501
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102
Practice Address - Country:US
Practice Address - Phone:505-727-3170
Practice Address - Fax:505-727-3171
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NMMD2018-0176207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM34354891Medicaid