Healthcare Provider Details

I. General information

NPI: 1225479702
Provider Name (Legal Business Name): ANAND NATH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2013
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 JOSEPH SIEWICK DR STE 406
FAIRFAX VA
22033-1761
US

IV. Provider business mailing address

PO BOX 37174
BALTIMORE MD
21297-3174
US

V. Phone/Fax

Practice location:
  • Phone: 703-391-3955
  • Fax: 703-391-3960
Mailing address:
  • Phone: 571-472-6253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0088998
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101283450
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: