1982630679 NPI number — NEHA B VYAS M.D.

Table of content: NEHA B VYAS M.D. (NPI 1982630679)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982630679 NPI number — NEHA B VYAS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VYAS
Provider First Name:
NEHA
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982630679
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24701 EUCLID AVE
Provider Second Line Business Mailing Address:
THIRD FLOOR - BILLING SERVICES
Provider Business Mailing Address City Name:
EUCLID
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44117-1714
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-425-2212
Provider Business Mailing Address Fax Number:
330-425-2779

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8819 COMMONS BLVD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TWINSBURG
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44087-4102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-425-2212
Provider Business Practice Location Address Fax Number:
330-425-2779
Provider Enumeration Date:
06/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  0101233433 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 35-098748 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 91227 . This is a "SENTARA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 323710 . This is a "AETNA HMO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1378007 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 245663 . This is a "SOUTHERN HEALTH SERVICES" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 144769 . This is a "ANTHEM BCBS OF VA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 2130759 . This is a "MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: P00153620 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010095051 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7508256 . This is a "AETNA LIFE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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