1487614913 NPI number — SATINDER S GILL MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487614913 NPI number — SATINDER S GILL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GILL
Provider First Name:
SATINDER
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1487614913
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1250 RESTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERNDON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20170
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-723-3670
Provider Business Mailing Address Fax Number:
703-723-8336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19455 DEERFIELD AVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
LANSDOWNE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20176-8446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-723-3670
Provider Business Practice Location Address Fax Number:
703-723-8336
Provider Enumeration Date:
03/27/2006

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: 207RG0100X , with the licence number:  0101226376 , 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: 7893425 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00089954 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2101256 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 265918 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2281866 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 161650640 . This is a "GROUP TAX ID #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2108755 . This is a "ALLIANCE MAMSI OPT CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3127432 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 005886651 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: G01769C01 . This is a "DC MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: H9900001 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 278305 . This is a "ANTHEM BCBS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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