Provider Demographics
NPI:1891740726
Name:AGGARWAL, ANITA (DO)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:AGGARWAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:SUITE 2A38
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2976
Mailing Address - Country:US
Mailing Address - Phone:202-865-3290
Mailing Address - Fax:202-865-3833
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:SUITE 2A38
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-865-3290
Practice Address - Fax:202-865-3833
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD31506207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC025801100Medicaid
VA5860661Medicaid
MD693102200Medicaid
DC830007685Medicare ID - Type UnspecifiedRAILROAD
MD693102200Medicaid
DC025801100Medicaid