Individual
DR. GAJAN A MAHENDIRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 HOSPITAL DR, WARRENTON, VA 20186-3027
(540) 349-0514
Mailing address
68 S. SERVICE RD., STE 350, MELVILLE, NY 11747-2358
(516) 945-3107
(516) 945-3131
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
0101237547
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396839346
—
VA
01
—
139698
ANTHEM
VA
01
—
296032
AMERIGROUP
VA
01
—
484645
NCPPO
VA
01
—
9396107
PHCS
VA
01
—
K142-0001
CARE FIRST 2005
VA
Enumeration date
10/03/2006
Last updated
04/02/2015
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