Provider Demographics
NPI:1003832502
Name:KALIM, ROSHAN (VA)
Entity Type:Individual
Prefix:DR
First Name:ROSHAN
Middle Name:
Last Name:KALIM
Suffix:
Gender:F
Credentials:VA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 ROSEMARY DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-7282
Mailing Address - Country:US
Mailing Address - Phone:703-257-3000
Mailing Address - Fax:412-586-9532
Practice Address - Street 1:10701 ROSEMARY DR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-7282
Practice Address - Country:US
Practice Address - Phone:703-257-3000
Practice Address - Fax:412-586-9532
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4267522084P0800X
VA0101244888207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD426752OtherMD LICENSE
PAMD426752OtherMD LICENSE