Healthcare Provider Details

I. General information

NPI: 1952396608
Provider Name (Legal Business Name): VIRENDRA K SAXENA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 MEDICAL CENTER DR
ROCKVILLE MD
20850-3357
US

IV. Provider business mailing address

PO BOX 1400
FAIRFAX VA
22038-1400
US

V. Phone/Fax

Practice location:
  • Phone: 301-517-9649
  • Fax:
Mailing address:
  • Phone: 703-383-9543
  • Fax: 703-383-9532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberD0030112
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: