Provider Demographics
NPI:1700879509
Name:BAGRI, HARJIT S (MD)
Entity Type:Individual
Prefix:
First Name:HARJIT
Middle Name:S
Last Name:BAGRI
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 1:224D CORNWALL ST NW STE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2704
Mailing Address - Country:US
Mailing Address - Phone:703-737-6001
Mailing Address - Fax:
Practice Address - Street 1:2505 VALLEY AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2761
Practice Address - Country:US
Practice Address - Phone:540-665-0084
Practice Address - Fax:540-665-9569
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232089207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5869064Medicaid
VA00V055D07Medicare PIN
VA5869064Medicaid