Provider Demographics
NPI:1679532493
Name:JINDAL, RAHUL M (MD)
Entity Type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:M
Last Name:JINDAL
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 1:404 HILTON HEAD CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905
Mailing Address - Country:US
Mailing Address - Phone:718-916-9241
Mailing Address - Fax:202-782-3186
Practice Address - Street 1:404 HILTON HEAD CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20905
Practice Address - Country:US
Practice Address - Phone:718-916-9241
Practice Address - Fax:202-782-3186
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238731-1208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02738287Medicaid
5341H1Medicare PIN