Individual
VIVAK MAHENDRA MASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4700 PUDDLEDOCK RD STE 400, PRINCE GEORGE, VA 23875-1268
(804) 458-1740
(804) 541-1846
Mailing address
8001 FRANKLIN FARMS DR RM 130, RICHMOND, VA 23229-5100
(804) 521-5800
(804) 545-4340
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0101259987
VA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
0101259987
VA
Other
Enumeration date
04/03/2012
Last updated
07/30/2020
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