Provider Demographics
NPI:1194943555
Name:MEHAN, VINEET (MD)
Entity type:Individual
Prefix:
First Name:VINEET
Middle Name:
Last Name:MEHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2735
Mailing Address - Street 2:
Mailing Address - City:MERRIFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22116-2735
Mailing Address - Country:US
Mailing Address - Phone:703-544-8971
Mailing Address - Fax:703-662-3457
Practice Address - Street 1:2755 HARTLAND RD
Practice Address - Street 2:SUITE 300
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-3540
Practice Address - Country:US
Practice Address - Phone:703-544-8971
Practice Address - Fax:703-662-3457
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2016-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101243422208200000X
MDD67453208200000X
DCMD037222208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery