| Vj 96 Llc | |
|
400 E Burwell St Salem VA 24153-4329 | |
| (540) 387-3105 | |
| (540) 387-3653 |
| Full Name | Vj 96 Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 400 E Burwell St, Salem, Virginia |
| Authorized Official Name and Position | Jagdeep Singh Wander (OWNER/PSYCHIATRIST) |
| Authorized Official Contact | 5403975718 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vj 96 Llc 400 E Burwell St Salem VA 24153-4329 Ph: (540) 387-3105 | Vj 96 Llc 400 E Burwell St Salem VA 24153-4329 Ph: (540) 387-3105 |
| NPI Number | 1679375299 |
|---|---|
| Provider Enumeration Date | 03/25/2025 |
| Last Update Date | 03/25/2025 |
| Certification Date | 03/25/2025 |
| Medicare PECOS PAC ID | 4789193699 |
|---|---|
| Medicare Enrollment ID | O20250603000648 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679375299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jagdeep S Wander |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851527592 PECOS PAC ID: 7719132687 Enrollment ID: I20130226000054 |
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