Provider Demographics
NPI:1760648059
Name:SARDANA, NITIN KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:NITIN
Middle Name:KUMAR
Last Name:SARDANA
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 1:3700 JOSEPH SIEWICK DR STE 308
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-1739
Mailing Address - Country:US
Mailing Address - Phone:703-698-8960
Mailing Address - Fax:703-716-8703
Practice Address - Street 1:3700 JOSEPH SIEWICK DR STE 308
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033
Practice Address - Country:US
Practice Address - Phone:703-698-8960
Practice Address - Fax:647-646-4744
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC148195207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine