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General NPI Number Information
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NPI Number | 1003931767
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Entity Type | Individual
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Provider Name | NIRAJ GOVIL M.D
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 5840 CAMERON RUN TER APT 1115
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City | ALEXANDRIA
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State | VA
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Zip | 22303-1811
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Country | US
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Telephone | 240-612-1076
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Fax |
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Provider Business Mailing Address
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Address Line | 1060 W PERIMETER RD STE 3K43
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City | JB ANDREWS
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State | MD
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Zip | 20762-6602
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Country | US
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Telephone | 937-938-3097
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Fax |
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | MA66454
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License Number State | NJ
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