Provider Demographics
NPI:1023108370
Name:KHARBANDA, NIRMALA (MD)
Entity type:Individual
Prefix:DR
First Name:NIRMALA
Middle Name:
Last Name:KHARBANDA
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 1:6090 FRANCONIA RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-4430
Mailing Address - Country:US
Mailing Address - Phone:703-922-0021
Mailing Address - Fax:703-922-0035
Practice Address - Street 1:6090 FRANCONIA RD
Practice Address - Street 2:SUITE A
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-4430
Practice Address - Country:US
Practice Address - Phone:703-922-0021
Practice Address - Fax:703-922-0035
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034671208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006727476Medicaid
VA006727476Medicaid
VAB95153Medicare UPIN