Healthcare Provider Details

I. General information

NPI: 1760411631
Provider Name (Legal Business Name): INDIRA SINHA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 01/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17618 MAIN ST
DUMFRIES VA
22026-2359
US

IV. Provider business mailing address

17618 MAIN ST
DUMFRIES VA
22026-2359
US

V. Phone/Fax

Practice location:
  • Phone: 703-441-8998
  • Fax: 703-445-8568
Mailing address:
  • Phone: 703-441-8998
  • Fax: 703-445-8568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101058138
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: