Provider Demographics
NPI:1346238342
Name:KHARDORI, NANCY M (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:KHARDORI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:MISRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-8999
Mailing Address - Fax:757-446-7922
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 572
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-8999
Practice Address - Fax:757-446-7922
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249621207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA-032OtherTRICARE/CHAMPUS
VA1346237342OtherFIRST HEALTH COMMERCIAL/COVENTRY HEALTH/SOUTHERN HEALTH
VA438969OtherANTHEM BC/BS
NC5918137Medicaid
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherCIGNA
VA1346238342OtherUNITED HEALTHCARE/MAMSI
VA1346238342Medicaid
VAPAROtherUSA MANAGED CARE
VAPAROtherCORVEL
VAPAROtherMULTIPLAN
VA10081480OtherOPTIMA HEALTH
VA1346238342OtherVIRGINIA PREMIER HEALTH PLAN
VAPAROtherAETNA
B23928Medicare UPIN
VAP01028263Medicare PIN
VA10081480OtherOPTIMA HEALTH