Individual
DR. PADMA KANT SHUKLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD FACP FACC
Contact information
Practice address
1860 TOWN CENTER DR, SUITE #210, RESTON, VA 20190
(703) 481-6999
(703) 437-1101
Mailing address
1860 TOWN CENTER DRIVE, SUITE #210, RESTON, VA 20190
(703) 481-6999
(703) 437-1101
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101038073
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6096018
—
VA
Enumeration date
09/22/2006
Last updated
11/27/2012
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