Provider Demographics
NPI:1093897597
Name:WASAN, ANITA NANDA (MD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:NANDA
Last Name:WASAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8115 OLD DOMINION DR
Mailing Address - Street 2:STE 220
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-2324
Mailing Address - Country:US
Mailing Address - Phone:703-992-7065
Mailing Address - Fax:703-992-7063
Practice Address - Street 1:19450 DEERFIELD AVE
Practice Address - Street 2:SUITE 335
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-6820
Practice Address - Country:US
Practice Address - Phone:703-729-8933
Practice Address - Fax:703-729-5996
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2016-09-24
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Provider Licenses
StateLicense IDTaxonomies
VA0101237864207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology