Healthcare Provider Details

I. General information

NPI: 1841203106
Provider Name (Legal Business Name): VIRGINIA MEDICAL ARTS CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13505 DULLES TECHNOLOGY DR SUITE 1A
HERNDON VA
20171-3401
US

IV. Provider business mailing address

P.O. BOX 505
HERNDON VA
20172-0505
US

V. Phone/Fax

Practice location:
  • Phone: 703-437-3850
  • Fax:
Mailing address:
  • Phone: 703-437-3850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAJEEV KHANNA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 703-437-3850