MEDICARE: DR. RAVNEET GREWAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0101220924	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2126931	OTHER	VA	MAMSI ONCOLOGY
2	8834468	OTHER	VA	CIGNA
3	3376538	OTHER	VA	AETNA PPO
4	7250194	OTHER	VA	AETNA HMO
5	3126931	OTHER	VA	MAMSI HEMATOLOGY
6	4126931	OTHER	VA	MAMSI INTERNAL MEDICINE

General Provider Information

NPI Number	:	1649271750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAVNEET GREWAL M.D.

Provider Business Mailing Address
First Line	:	19415 DEERFIELD AVE
Second Line	:	SUITE 107
City	:	LANSDOWNE
State	:	VA
Zip	:	20176-8452
Country	:	US
Telephone Number	:	703-729-6030
Fax Number	:	703-729-1446

Provider Business Practice Location Address
First Line	:	19415 DEERFIELD AVE
Second Line	:	SUITE 107
City	:	LANSDOWNE
State	:	VA
Zip	:	20176-8452
Country	:	US
Telephone Number	:	703-729-6030
Fax Number	:	703-729-1446

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	03/25/2008

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Directions to “ DR. RAVNEET GREWAL M.D.” Practice Location

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