Basic Information
| Provider Information | |||||||||
| NPI: | 1225002645 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PUROHIT | ||||||||
| FirstName: | GIRISH | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 W 3RD ST | ||||||||
| Address2: | |||||||||
| City: | FARMVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 239011131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4343924370 | ||||||||
| FaxNumber: | 4343926023 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 W 3RD ST | ||||||||
| Address2: | |||||||||
| City: | FARMVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 239011131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4343924370 | ||||||||
| FaxNumber: | 4343926023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2006 | ||||||||
| LastUpdateDate: | 02/08/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 0101027862 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 005805473 | 05 | VA | MEDICAID |