Provider Demographics
NPI:1235162793
Name:LOUDOUN CARDIOVASCULAR SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:LOUDOUN CARDIOVASCULAR SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJAT
Authorized Official - Middle Name:
Authorized Official - Last Name:GARG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-723-5520
Mailing Address - Street 1:19455 DEERFIELD AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8446
Mailing Address - Country:US
Mailing Address - Phone:703-723-5520
Mailing Address - Fax:703-723-5548
Practice Address - Street 1:19455 DEERFIELD AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8446
Practice Address - Country:US
Practice Address - Phone:703-723-5520
Practice Address - Fax:703-723-5548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCDF0546OtherMEDICARE RAILROAD DC
VADF0545OtherMEDICARE RAILROAD VA
DCG02328Medicare PIN
VAC09837Medicare PIN