Healthcare Provider Details

I. General information

NPI: 1811063118
Provider Name (Legal Business Name): JEEVINDRA SINGH RANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 S CARLIN SPRINGS RD SUITE 511
ARLINGTON VA
22204-1064
US

IV. Provider business mailing address

611 S CARLIN SPRINGS RD SUITE 511
ARLINGTON VA
22204-1064
US

V. Phone/Fax

Practice location:
  • Phone: 703-671-7000
  • Fax: 703-379-0449
Mailing address:
  • Phone: 703-671-7000
  • Fax: 703-379-0449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101057788
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: