Individual
MOHAN T VAIDY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4924 COCHISE TRL, RICHMOND, VA 23237-2568
(804) 524-7000
(804) 524-4717
Mailing address
CENTRAL STATE HOSPITAL, P.O.BOX 4030, PETERSBURG, VA 23803
(804) 524-7000
(804) 524-4717
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101031585
VA
Other
Enumeration date
01/04/2006
Last updated
07/08/2007
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