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General NPI Number Information
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NPI Number | 1174458194
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Entity Type | Organization
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Legal Business Name | TABULA MEDICA LLC
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Dates
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Enumeration Date | 06/13/2026
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Last Update Date | 06/13/2026
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Provider Practice Location Address
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Address Line | 19415 DEERFIELD AVE STE 103
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City | LANSDOWNE
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State | VA
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Zip | 20176-8470
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Country | US
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Telephone | 703-957-8205
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Fax | 571-223-3834
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Provider Business Mailing Address
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Address Line | 19415 DEERFIELD AVE STE 103
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City | LANSDOWNE
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State | VA
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Zip | 20176-8470
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Country | US
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Telephone | 703-957-8205
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Fax | 571-223-3834
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Authorized Official
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Title or Position | CEO
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Name | DR. RAJIV KUMAR AGGARWAL
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Credential |
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Telephone | 703-732-5625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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