Vijaykumar R Phade MD PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

12519 Issued in WV

Legal business name

VIJAYKUMAR R PHADE MD PC

Practice address

496 Cherry St
BLDG C Ste a
Bluefield, WV 24701-3304

Phone

(304) 327-7476

Fax

(304) 327-7476

NPI assigned

Oct 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vijaykumar R Phade, M.D.

Title

President

Phone

(304) 327-7476

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Vijaykumar R. Phade MD Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandeep Vardan, MD

  • Specialist
  • Bluefield, WV
  • NPI 1073676110
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1952590432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1553",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247011553",
            "telephone_number": "304-327-7476",
            "fax_number": "304-327-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 CHERRY ST",
            "address_2": "BLDG C STE A",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247013304",
            "telephone_number": "304-327-7476",
            "fax_number": "304-327-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIJAYKUMAR R PHADE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "PHADE",
        "authorized_official_first_name": "VIJAYKUMAR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-327-7476",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "WV",
            "license": "12519",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "WV",
            "license": "12519",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020000431",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007394322",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0128227000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vijaykumar R. Phade MD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Danielle Marie Vance
• Jennifer Ann Vanover
• Sarah Bell Vanover
• Sandeep Vardan, MD
• Milagros Mercedes Vidot, M.D.
• Brandon Scott Vincent, PRSS
• Virginias Dermatology, Inc.
• Robert A Wade, O.D.
• Walgreen Co
• Walgreen Co.

• Surgery Physician in Bluefield, WV
• Providers in Bluefield, WV by specialty
• Surgery Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.