Provider Demographics
NPI:1902617442
Name:AB OPTIMAL MEDICALCARE LLC
Entity type:Organization
Organization Name:AB OPTIMAL MEDICALCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANISH
Authorized Official - Middle Name:J
Authorized Official - Last Name:BADODARIYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-929-2421
Mailing Address - Street 1:12013 IVY HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7531
Mailing Address - Country:US
Mailing Address - Phone:804-929-2421
Mailing Address - Fax:804-282-9133
Practice Address - Street 1:12013 IVY HOLLOW CT
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-7531
Practice Address - Country:US
Practice Address - Phone:804-929-2421
Practice Address - Fax:804-282-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty