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General NPI Number Information
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NPI Number | 1528180551
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Entity Type | Organization
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Legal Business Name | RAVINDER K RUSTAGI M.D.P.A
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 6132 LANDOVER RD
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City | CHEVERLY
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State | MD
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Zip | 20785-1022
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Country | US
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Telephone | 301-386-2666
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Fax | 301-386-2085
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Provider Business Mailing Address
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Address Line | 9333 BELLE TERRE WAY
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City | POTOMAC
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State | MD
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Zip | 20854-4643
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Country | US
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Telephone | 301-765-2256
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Fax | 301-765-3369
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAVINDER K RUSTAGI
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Credential | M.D.
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Telephone | 301-386-2666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D24720
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License Number State | MD
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