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General NPI Number Information
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NPI Number | 1003105875
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Entity Type | Individual
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Provider Name | SHIVANGI VACHHANI M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/01/2011
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 3700 JOSEPH SIEWICK DR STE 408A
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City | FAIRFAX
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State | VA
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Zip | 22033-1745
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Country | US
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Telephone | 877-511-4625
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Fax | 703-204-9006
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Provider Business Mailing Address
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Address Line | 211 GIBSON ST NW STE 220
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City | LEESBURG
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State | VA
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Zip | 20176-2115
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Country | US
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Telephone | 877-511-4625
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Fax | 703-669-2466
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD041888
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 0101255671
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License Number State | VA
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