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Individual

DR. GURU PRAKASH MOHANTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1001 BOULDERS PKWY STE 110, NORTH CHESTERFIELD, VA 23225
(804) 410-9749
Mailing address
1001 BOULDERS PKWY STE 110, NORTH CHESTERFIELD, VA 23225-5513
(804) 410-9749

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0101258871
VA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
0101258871
VA
207RC0001X
Clinical Cardiac Electrophysiology Physician
MD19842
ME

Other

Enumeration date
01/26/2008
Last updated
07/02/2019
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