Provider Demographics
NPI:1962411504
Name:PANDEYA, VIRAG (MD)
Entity type:Individual
Prefix:DR
First Name:VIRAG
Middle Name:
Last Name:PANDEYA
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 1:201 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1708
Mailing Address - Country:US
Mailing Address - Phone:270-524-1201
Mailing Address - Fax:270-506-5972
Practice Address - Street 1:950 MAIN ST
Practice Address - Street 2:
Practice Address - City:MUNFORDVILLE
Practice Address - State:KY
Practice Address - Zip Code:42765-9435
Practice Address - Country:US
Practice Address - Phone:270-524-1201
Practice Address - Fax:270-506-5972
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38368207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine