Provider Demographics
NPI:1780777912
Name:MANGAT, HARPAL SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:HARPAL
Middle Name:SINGH
Last Name:MANGAT
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 1:20528 BOLAND FARM RD STE 109
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4032
Mailing Address - Country:US
Mailing Address - Phone:301-515-3333
Mailing Address - Fax:301-515-3322
Practice Address - Street 1:20528 BOLAND FARM RD STE 109
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4032
Practice Address - Country:US
Practice Address - Phone:301-515-3333
Practice Address - Fax:301-515-3322
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058756208D00000X, 207R00000X, 208D00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD410453600Medicaid
DC09670002OtherCAREFIRST BCBS
MD130459ZAHAMedicare PIN
MD410453600Medicaid
DCG02790C02Medicare PIN