VIVAK MAHENDRA MASTER (NPI# 1386900397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386900397 |
Entity Type | Individual |
Full Name | VIVAK MAHENDRA MASTER |
Credential | M.D. |
Practice Address |
4700 Puddledock Rd Ste 400 Prince George VA 23875-1268 |
Mailing Address |
8001 Franklin Farms Dr Rm 130 Richmond VA 23229-5100 |
Practice Telephone | 8044581740 |
Practice Fax Number | 8045411846 |
Mailing Telephone | 8045215800 |
Mailing Fax Number | 8045454340 |
Enumeration Date | 2012-04-03 |
Last Update Date | 2020-07-30 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
0101259987 | VA | Allopathic & Osteopathic Physicians |
Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
0101259987 | VA | Allopathic & Osteopathic Physicians |
Street Address |
4700 PUDDLEDOCK RD STE 400 |
City | PRINCE GEORGE |
State | VA |
Zip Code | 23875-1268 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083228902 | Lr Counseling Services, LLC | Community/Behavioral Health | 5000 Owens Way, Apt. 622, Prince George, VA 23875 | 2020-09-08 |
1053815423 | Yolanda Larrette Hoag | Nurse Practitioner | 4600 Puddledock Rd, Prince George, VA 23875 | 2018-03-21 |
1932534864 | Foundation for Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4301 Montreal Ave., Prince George, VA 23875 | 2013-09-11 |
1073889697 | Jemina M Liverman | Nurse Practitioner | 4260 Crossing Blvd, Prince George, VA 23875 | 2012-03-28 |
1245412717 | Prince George County Public Schools | Local Education Agency (LEA) | 6410 Courts Drive, Prince George, VA 23875 | 2007-11-27 |
1952330193 | Commonwealth of Virginia State Board of Health | Public Health or Welfare | 6459 Administration Dr., Prince George, VA 23875 | 2006-07-01 |
1598173155 | Divine Spine Chiropractic | Chiropractor | 4205 Crossings Blvd, Prince George, VA 23875 | 2014-07-28 |
1669632782 | Ashif K Jethava | Internal Medicine | 4720 Puddledock Rd, Suite 100b, Prince George, VA 23875 | 2008-06-12 |
1043873664 | Branbur Dialysis LLC | Clinic/Center | 4650 Puddledock Rd, Prince George, VA 23875-1235 | 2019-04-18 |
1033754874 | Jessica M Larche | Nurse Practitioner | 4600 Puddledock Rd, Prince George, VA 23875-1235 | 2019-11-15 |
Find all providers in zip 23875 |
Taxonomy Code | 207RC0001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Clinical Cardiac Electrophysiology |
A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154701878 | Nmg Affiliate Practice I, LLC | Internal Medicine | 8567 Sudley Rd Ste B, Manassas, VA 20110-3865 | 2015-06-08 |
1497943344 | Saumil R Shah | Internal Medicine | 1001 Boulders Pkwy Ste 110, North Chesterfield, VA 23225 | 2007-10-04 |
1770671711 | Sarfraz Durrani | Internal Medicine | 3020 Hamaker Ct Ste 401, Fairfax, VA 22031-2220 | 2006-10-11 |
1376630988 | Neoma S George | Internal Medicine | 4000 Coliseum Dr Ste 445, Hampton, VA 23666-5981 | 2006-10-06 |
1205819521 | Scott Kaufman | Internal Medicine | 500 J Clyde Morris Blvd Ste A, Newport News, VA 23601-1929 | 2005-11-21 |
1306304217 | Virginia Arrhythmia Consultants Pllc | Internal Medicine | 1001 Boulders Pkwy Ste 110, North Chesterfield, VA 23225-5513 | 2019-03-10 |
1356850598 | Oliver James Monfredi | Internal Medicine | 500 Ray C Hunt Dr, Charlottesville, VA 22903-2981 | 2017-09-20 |
1104163542 | Fairfax Arrhythmia, Pllc | Internal Medicine | 3020 Hamaker Ct, Suite 401, Fairfax, VA 22031-2238 | 2013-01-04 |
1265731491 | Stephen Andrew Gaeta | Internal Medicine | 3020 Hamaker Ct Ste 101, Fairfax, VA 22031-2233 | 2011-03-28 |
1396056982 | Fort Norfolk Plaza Medical Associates, LLC | Internal Medicine | 301 Riverview Ave Ste 500, Norfolk, VA 23510-1066 | 2010-06-29 |
Find all providers with the same taxonomy |
City | PRINCE GEORGE |
Zip Code | 23875 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.