Provider Demographics
NPI:1215120183
Name:SOOD, VINEETA (MD)
Entity type:Individual
Prefix:
First Name:VINEETA
Middle Name:
Last Name:SOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 BOULEVARD
Mailing Address - Street 2:SUITE C
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1338
Mailing Address - Country:US
Mailing Address - Phone:804-504-0068
Mailing Address - Fax:804-504-0080
Practice Address - Street 1:3601 BOULEVARD
Practice Address - Street 2:SUITE C
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1338
Practice Address - Country:US
Practice Address - Phone:804-504-0068
Practice Address - Fax:804-504-0080
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1157207RN0300X, 207R00000X
VA0101251816207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAGC1009Medicare PIN