Provider Demographics
NPI:1962664177
Name:DHAR, RACHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHNA
Middle Name:
Last Name:DHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WEST BROADDUS AVENUE
Mailing Address - Street 2:CAROLINA FAMILY PRACTICE
Mailing Address - City:BOWLING GREEN
Mailing Address - State:VA
Mailing Address - Zip Code:22427
Mailing Address - Country:US
Mailing Address - Phone:203-520-5583
Mailing Address - Fax:
Practice Address - Street 1:102 WEST BROADDUS AVENUE
Practice Address - Street 2:CAROLINA FAMILY PRACTICE
Practice Address - City:BOWLING GREEN
Practice Address - State:VA
Practice Address - Zip Code:22427
Practice Address - Country:US
Practice Address - Phone:203-520-5583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD434756207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101247496OtherVIRGINIA BOARD OF MEDICINE
CT46910OtherCONNECTICUT BOARD OF MEDICINE
PAMD434756OtherMEDICAL LICENSE
PA867633OtherGROUP MEDICARE #
PAFD0923258OtherDEA