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Individual

DR. ANIL MATHEW CHENTHITTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
19450 DEERFIELD AVE STE 280, LEESBURG, VA 20176-6821
(571) 510-3815
(571) 510-3675
Mailing address
19450 DEERFIELD AVE STE 280, LEESBURG, VA 20176-6821
(571) 510-3815
(571) 510-3675

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
0101252929
VA
208VP0014X
Interventional Pain Medicine Physician
ME128763
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101252929
LICENSE NO
VA
05
1275769168
VA
01
P01159671
RR MEDICARE
VA
Enumeration date
06/05/2009
Last updated
03/24/2020
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