Healthcare Provider Details

I. General information

NPI: 1609213677
Provider Name (Legal Business Name): DR. ASHWINI K SARDANA, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 07/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 BELCREST RD STE 110
HYATTSVILLE MD
20782-2011
US

IV. Provider business mailing address

6505 BELCREST RD STE 110
HYATTSVILLE MD
20782-2011
US

V. Phone/Fax

Practice location:
  • Phone: 301-699-0003
  • Fax:
Mailing address:
  • Phone: 301-699-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHWINI K SARDANA
Title or Position: MD
Credential:
Phone: 703-618-6797