Provider Demographics
NPI:1649449166
Name:MULTANI, MANPREET (MD)
Entity type:Individual
Prefix:DR
First Name:MANPREET
Middle Name:
Last Name:MULTANI
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:PO BOX 37189
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3189
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:130 PARK ST SE STE 200
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4626
Practice Address - Country:US
Practice Address - Phone:703-938-7800
Practice Address - Fax:703-938-4541
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01066468A207Q00000X
MIL1162300207Q00000X
VA0101260207207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200952450Medicaid
IN558430050Medicare PIN