Provider Demographics
NPI:1831102185
Name:GOGIA, AMIT (MD)
Entity type:Individual
Prefix:DR
First Name:AMIT
Middle Name:
Last Name:GOGIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8262 ATLEE RD
Mailing Address - Street 2:MOB III, SUITE 205
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1816
Mailing Address - Country:US
Mailing Address - Phone:804-559-0194
Mailing Address - Fax:804-559-0198
Practice Address - Street 1:8262 ATLEE RD
Practice Address - Street 2:MOB III, SUITE 205
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-1816
Practice Address - Country:US
Practice Address - Phone:804-559-0194
Practice Address - Fax:804-559-0198
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2009-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101239131208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00454458OtherRAILROAD MEDICARE ID
VA012467547Medicare PIN
VAP00454458OtherRAILROAD MEDICARE ID