Provider Demographics
NPI:1952346066
Name:MATHUR, NAVDEEP (MD)
Entity Type:Individual
Prefix:
First Name:NAVDEEP
Middle Name:
Last Name:MATHUR
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 1:8428 DORSEY CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-8302
Mailing Address - Country:US
Mailing Address - Phone:571-379-8827
Mailing Address - Fax:888-224-4936
Practice Address - Street 1:8428 DORSEY CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-8302
Practice Address - Country:US
Practice Address - Phone:571-379-8827
Practice Address - Fax:888-224-4936
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101240433207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1972892065OtherCOPORATE NPI