Individual
DR. PREM MANCHANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4100 ORCHARD DR, FAIRFAX, VA 22032-1021
(703) 981-4865
(804) 414-7762
Mailing address
4660 KENMORE AVE, SUIYE 220, ALEXANDRIA, VA 22304-1313
(703) 910-3484
(804) 414-7762
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101057630
VA
207R00000X
Internal Medicine Physician
D54095
MD
Other
Enumeration date
12/28/2006
Last updated
11/27/2023
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