Provider Demographics
NPI:1013172907
Name:LAKHANPAL, GAURAV (MD)
Entity Type:Individual
Prefix:
First Name:GAURAV
Middle Name:
Last Name:LAKHANPAL
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 1:7300 HANOVER DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2202
Mailing Address - Country:US
Mailing Address - Phone:301-486-4690
Mailing Address - Fax:301-486-4692
Practice Address - Street 1:7300 HANOVER DR
Practice Address - Street 2:SUITE 104
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2202
Practice Address - Country:US
Practice Address - Phone:301-486-4690
Practice Address - Fax:301-486-4692
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0077608207RI0011X
NC2008-01683207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00652646OtherRAILROAD MEDICARE
NC150WKOtherBCBSNC
NC5910796Medicaid
NC150WKOtherBCBSNC