Provider Demographics
NPI:1871966523
Name:VIRTUAL CONSULT MD LLC
Entity type:Organization
Organization Name:VIRTUAL CONSULT MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GAURAV
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUSHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-997-7382
Mailing Address - Street 1:5444 E INDIANA ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2857
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5444 E INDIANA ST
Practice Address - Street 2:SUITE 109
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2857
Practice Address - Country:US
Practice Address - Phone:812-848-2322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty