MEDICARE: DR. HABIB A. CHOTANI 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	207R00000X	Internal Medicine Physician	0101242050	VA
2	207R00000X	Internal Medicine Physician	D0058853	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992702112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HABIB A. CHOTANI M.D.

Provider Business Mailing Address
First Line	:	4660 KENMORE AVE
Second Line	:	SUITE 600
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4660 KENMORE AVE
Second Line	:	SUITE 600
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1313
Country	:	US
Telephone Number	:	703-212-9190
Fax Number	:

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	12/26/2018

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