1003895475 NPI number — DR. HIREN GANDHI M.D.

Table of content: DR. HIREN GANDHI M.D. (NPI 1003895475)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003895475 NPI number — DR. HIREN GANDHI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GANDHI
Provider First Name:
HIREN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1003895475
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3801 FAIRFAX DR
Provider Second Line Business Mailing Address:
STE#44
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22203-1762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-522-4780
Provider Business Mailing Address Fax Number:
703-527-8695

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3801 FAIRFAX DR
Provider Second Line Business Practice Location Address:
STE#44
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22203-1762
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-522-4780
Provider Business Practice Location Address Fax Number:
703-527-8695
Provider Enumeration Date:
01/12/2006

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: 208000000X , with the licence number:  0101232755 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2319508 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7054361 . This is a "AETNA PPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 3231297 . This is a "AETNA HMO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010451 . This is a "HEALTHKEEPERS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 39739 . This is a "UNICARE MC/FAMIS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 8117669 . This is a "MDIPA/OPT CHOICE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 519285 . This is a "NCPPO/HEALTHLINK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 3842619 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: C017-0002 . This is a "CARE FIRST BCBS(DC)" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 2117669 . This is a "MAMSI/ALLIANCE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010451 . This is a "ANTHEM BCBS(VA)" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7054361 . This is a "AETNA POS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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