Individual
BARRY R MAHARAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
19441 GOLF VISTA PLZ, SUITE 130, LANSDOWNE, VA 20176-8269
(703) 723-7858
(703) 723-7882
Mailing address
19441 GOLF VISTA PLZ, SUITE 130, LANSDOWNE, VA 20176-8269
(703) 723-7858
(703) 723-7882
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0438000127
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008000531
—
VA
01
—
292375
MAMSI/ALLIANCE
—
01
—
384338
ANTHEM BCBS
—
Enumeration date
07/20/2006
Last updated
06/27/2013
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