Provider Demographics
NPI:1710901202
Name:KHURANA, CHARANJIT S (MD)
Entity Type:Individual
Prefix:
First Name:CHARANJIT
Middle Name:S
Last Name:KHURANA
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 1:1715 N GEORGE MASON DR
Mailing Address - Street 2:STE 107
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205
Mailing Address - Country:US
Mailing Address - Phone:703-527-1400
Mailing Address - Fax:703-225-0043
Practice Address - Street 1:1715 N GEORGE MASON DR
Practice Address - Street 2:STE 107
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205
Practice Address - Country:US
Practice Address - Phone:703-527-1400
Practice Address - Fax:703-225-0043
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235014207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
05149844OtherECFMG
H97423Medicare UPIN
012790H98Medicare ID - Type Unspecified