MEDICARE: ANIL TANEJA 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	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	239943	NY
2	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	D0073753	MD
3	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	0101050459	VA

General Provider Information

NPI Number	:	1396736005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIL TANEJA MD

Provider Business Mailing Address
First Line	:	8008 WESTPARK DR
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3109
Country	:	US
Telephone Number	:	703-287-6475
Fax Number	:	703-287-6476

Provider Business Practice Location Address
First Line	:	8008 WESTPARK DR
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3109
Country	:	US
Telephone Number	:	703-287-6475
Fax Number	:	703-287-6476

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	05/27/2021

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