Provider Demographics
NPI:1366530198
Name:MANU R. GADANI, MD PC INC
Entity type:Organization
Organization Name:MANU R. GADANI, MD PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANU
Authorized Official - Middle Name:R
Authorized Official - Last Name:GADANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-458-2006
Mailing Address - Street 1:5303 PLAZA DR
Mailing Address - Street 2:SUITE--101
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-7331
Mailing Address - Country:US
Mailing Address - Phone:804-458-3629
Mailing Address - Fax:
Practice Address - Street 1:5303 PLAZA DR
Practice Address - Street 2:SUITE--101
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-7331
Practice Address - Country:US
Practice Address - Phone:804-458-3629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053054207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010558OtherCIGNA
VA110212740OtherRAILROAD MEDICARE
VA006002714Medicaid
VA230297OtherBLUE SHIELD/ANTHEUM
VA010558OtherCIGNA
VA006002714Medicaid