Provider Demographics
NPI:1033130794
Name:RANA, IRMINDRA S (MD)
Entity type:Individual
Prefix:DR
First Name:IRMINDRA
Middle Name:S
Last Name:RANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1985 AIKEN HILL COURT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-1548
Mailing Address - Country:US
Mailing Address - Phone:703-994-0480
Mailing Address - Fax:703-379-0449
Practice Address - Street 1:611 S CARLIN SPRINGS RD
Practice Address - Street 2:SUITE 301
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1064
Practice Address - Country:US
Practice Address - Phone:703-998-0480
Practice Address - Fax:703-379-0449
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2011-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101233375207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010083869Medicaid
VA010083869Medicaid
DCG01732I01Medicare ID - Type Unspecified