Provider Demographics
NPI:1164608568
Name:TIRMAL, VIRAJ V (MD)
Entity Type:Individual
Prefix:DR
First Name:VIRAJ
Middle Name:V
Last Name:TIRMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 NATIONAL DR STE 220
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-6106
Mailing Address - Country:US
Mailing Address - Phone:240-389-1986
Mailing Address - Fax:833-449-5686
Practice Address - Street 1:3905 NATIONAL DR STE 220
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-6106
Practice Address - Country:US
Practice Address - Phone:240-389-1986
Practice Address - Fax:833-449-5686
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0096880207R00000X
FLME102836207R00000X, 208M00000X
NY250810208M00000X, 207R00000X
CT047005208M00000X, 207R00000X
NJ25MA08488400208M00000X, 207R00000X
PAMD435561207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
171902SK3Medicare PIN
077356Medicare Oscar/Certification