Healthcare Provider Details

I. General information

NPI: 1386262863
Provider Name (Legal Business Name): VARUN JAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2020
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 UNIVERSITY BLVD STE A
HARRISONBURG VA
22801-3773
US

IV. Provider business mailing address

PO BOX 388
FISHERSVILLE VA
22939-0388
US

V. Phone/Fax

Practice location:
  • Phone: 540-932-5850
  • Fax: 540-932-5851
Mailing address:
  • Phone: 540-932-5168
  • Fax: 540-932-5862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number0101281739
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRL16543
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: