MEDICARE: SUBARNA B DHARIA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	0101238011	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023007564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUBARNA B DHARIA MD

Provider Business Mailing Address
First Line	:	12950 HIGHLAND CROSSING DRIVE
Second Line	:	STE. H
City	:	HERNDON
State	:	VA
Zip	:	20171
Country	:	US
Telephone Number	:	703-860-4200
Fax Number	:	703-860-1528

Provider Business Practice Location Address
First Line	:	12950 HIGHLAND CROSSING DRIVE
Second Line	:	STE. H
City	:	HERNDON
State	:	VA
Zip	:	20171
Country	:	US
Telephone Number	:	703-860-4200
Fax Number	:	703-860-1528

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	06/20/2014

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