Individual
DR. TARA MANGAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19415 DEERFIELD AVE, 310, LANSDOWNE, VA 20176-8452
(703) 858-0076
(703) 726-6394
Mailing address
PO BOX 825, ASHBURN, VA 20146-0825
(703) 858-0076
(703) 726-6394
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101232595
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146222
ANTHEM BC
VA
Enumeration date
12/21/2005
Last updated
02/27/2008
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