Provider Demographics
NPI:1184891665
Name:BISHWAKARMA, DAN B (MD)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:B
Last Name:BISHWAKARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:12581 MILSTEAD WAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5445
Mailing Address - Country:US
Mailing Address - Phone:703-897-5890
Mailing Address - Fax:703-897-5897
Practice Address - Street 1:12581 MILSTEAD WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192
Practice Address - Country:US
Practice Address - Phone:703-897-5890
Practice Address - Fax:703-897-5897
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2012-09-18
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Provider Licenses
StateLicense IDTaxonomies
VA0101243193207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine