Provider Demographics
NPI:1285841361
Name:PACHINBURAVAN, MONVASI (MD)
Entity type:Individual
Prefix:
First Name:MONVASI
Middle Name:
Last Name:PACHINBURAVAN
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 1:25 WASHINGTON LN
Mailing Address - Street 2:APT 626
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095-1403
Mailing Address - Country:US
Mailing Address - Phone:215-884-1124
Mailing Address - Fax:
Practice Address - Street 1:2006 HEALTH CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-8679
Practice Address - Country:US
Practice Address - Phone:540-689-5600
Practice Address - Fax:540-689-5601
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT184397207R00000X
VA0101257631207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine