Provider Demographics
NPI:1003105875
Name:VACHHANI, SHIVANGI (MD)
Entity Type:Individual
Prefix:
First Name:SHIVANGI
Middle Name:
Last Name:VACHHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHIVANGI
Other - Middle Name:
Other - Last Name:PANDYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:211 GIBSON ST NW STE 220
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2115
Mailing Address - Country:US
Mailing Address - Phone:877-511-4625
Mailing Address - Fax:703-669-2466
Practice Address - Street 1:3700 JOSEPH SIEWICK DR STE 408A
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1745
Practice Address - Country:US
Practice Address - Phone:877-511-4625
Practice Address - Fax:703-204-9006
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD041888207RE0101X
VA0101255671207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism