Organization
STATELINE HEART AND VASCULAR HEALTH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEPAK DILIP BANERJEE MD (PRESIDENT)
(757) 813-6493
Entity
Organization
Contact information
Practice address
312 FAIRY STREET EXT STE 101, MARTINSVILLE, VA 24112-1912
(757) 813-6493
Mailing address
20 HUNT COUNTRY FARMS RD, MARTINSVILLE, VA 24112-6622
(757) 813-6493
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101230554
VA
Other
Enumeration date
08/07/2017
Last updated
07/21/2022
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