Provider Demographics
NPI:1245946367
Name:MEDICAL CONSULTANT SERVICES LLC
Entity type:Organization
Organization Name:MEDICAL CONSULTANT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUGAL
Authorized Official - Middle Name:RAKESH
Authorized Official - Last Name:DHARIA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-200-2300
Mailing Address - Street 1:10721 MAIN ST STE 3500
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6909
Mailing Address - Country:US
Mailing Address - Phone:703-352-8888
Mailing Address - Fax:703-352-8994
Practice Address - Street 1:10721 MAIN ST STE 3500
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6909
Practice Address - Country:US
Practice Address - Phone:703-352-8888
Practice Address - Fax:703-352-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty