Provider Demographics
NPI:1770645368
Name:SHIRALI, SWATI SUDHEER (MD)
Entity Type:Individual
Prefix:DR
First Name:SWATI
Middle Name:SUDHEER
Last Name:SHIRALI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W
Mailing Address - Street 2:KAISER PERMANENTE MID ATL PERM MED GRP PC ATTN T BROOKS
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:12255 FAIR LAKES PARKWAY
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-4512
Practice Address - Country:US
Practice Address - Phone:703-934-5905
Practice Address - Fax:703-934-5778
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2021-06-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0074071207X00000X
CAG0819342086S0105X
VA0101222017207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
006564M92Medicare ID - Type Unspecified
MDG38779Medicare UPIN