Provider Demographics
NPI:1316046287
Name:CARDIOLOGY ASSOCIATES OF CENTRAL VIRGINIA, PC
Entity type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF CENTRAL VIRGINIA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVINDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:KOHLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-526-3010
Mailing Address - Street 1:89 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1447
Mailing Address - Country:US
Mailing Address - Phone:804-526-3010
Mailing Address - Fax:804-526-2293
Practice Address - Street 1:89 SHERWOOD DR
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1447
Practice Address - Country:US
Practice Address - Phone:804-526-3010
Practice Address - Fax:804-526-2293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047753174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005829038Medicaid
VA005829038Medicaid
VA060000934Medicare ID - Type Unspecified