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Individual

RAVINDER MOHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5320 PROVIDENCE RD, SUITE 301, VIRGINIA BEACH, VA 23464-4122
(757) 413-7600
(757) 507-9051
Mailing address
5320 PROVIDENCE RD, SUITE 301, VIRGINIA BEACH, VA 23464-4122
(757) 413-7600
(757) 507-9051

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101059248
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
-002 -003
TRICARE/CHAMPUS
VA
05
005604133
VA
05
005638411
VA
01
1992771521
AETNA
VA
05
790571Y
NC
01
PAR
MULTIPLAN
VA
Enumeration date
02/24/2006
Last updated
09/10/2018
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