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Individual

VISHNU GANTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
500 MARTHA JEFFERSON DR, CHARLOTTESVILLE, VA 22911-4668
(434) 654-7955
(434) 654-7944
Mailing address
115 GLENEAGLE, CORTLAND, OH 44410-8729
(615) 525-6167

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101288376
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD446742
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1134413651
VA
Enumeration date
06/01/2011
Last updated
03/05/2026
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