Provider Demographics
NPI:1629167077
Name:HEART SPECIALISTS OF NORTHERN VIRGINIA, P.C.
Entity Type:Organization
Organization Name:HEART SPECIALISTS OF NORTHERN VIRGINIA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MRINAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-813-1242
Mailing Address - Street 1:5514 ALMA LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-4000
Mailing Address - Country:US
Mailing Address - Phone:703-813-1242
Mailing Address - Fax:703-916-0592
Practice Address - Street 1:5514 ALMA LN
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-4000
Practice Address - Country:US
Practice Address - Phone:703-813-1242
Practice Address - Fax:703-916-0592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG00200Medicare ID - Type Unspecified