Provider Demographics
NPI:1851547756
Name:VIDWAN, JASKIRAN KAUR (DO)
Entity Type:Individual
Prefix:DR
First Name:JASKIRAN
Middle Name:KAUR
Last Name:VIDWAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JASKIRAN
Other - Middle Name:KAUR
Other - Last Name:JHAJJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:8555 16TH ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2816
Mailing Address - Country:US
Mailing Address - Phone:301-562-7200
Mailing Address - Fax:301-563-7199
Practice Address - Street 1:1201 SEVEN LOCKS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20854-2931
Practice Address - Country:US
Practice Address - Phone:301-562-7200
Practice Address - Fax:301-424-1565
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH00799762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH0079976OtherMD STATE LICENSE