Provider Demographics
NPI:1669583910
Name:KATARKI, BIJAL (MD)
Entity type:Individual
Prefix:
First Name:BIJAL
Middle Name:
Last Name:KATARKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BIJAL
Other - Middle Name:VINAYAK
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1860 TOWN CENTER DR
Mailing Address - Street 2:STE 310
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3292
Mailing Address - Country:US
Mailing Address - Phone:703-435-0700
Mailing Address - Fax:703-435-0660
Practice Address - Street 1:1860 TOWN CENTER DR
Practice Address - Street 2:STE 310
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3292
Practice Address - Country:US
Practice Address - Phone:703-435-0700
Practice Address - Fax:703-435-0660
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235161207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010019770Medicaid
VA010019770Medicaid
H81197Medicare UPIN
012613D74Medicare ID - Type Unspecified