Healthcare Provider Details

I. General information

NPI: 1205256591
Provider Name (Legal Business Name): KIRAN KALRA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2014
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD
FALLS CHURCH VA
22042-3307
US

IV. Provider business mailing address

25853 CAMERON WALK PLACE
ALDIE VA
20105
US

V. Phone/Fax

Practice location:
  • Phone: 240-330-3106
  • Fax:
Mailing address:
  • Phone: 240-330-3106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101262689
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101262689
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: