Individual
MANGALA H PAWAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14113 ROBERT PARIS CT, CHANTILLY, VA 20151-4200
(703) 956-6757
(855) 359-2261
Mailing address
14133 ROBERT PARIS CT, CHANTILLY, VA 20151-4203
(703) 956-6757
(855) 359-2261
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
D0056232
MD
208000000X
Pediatrics Physician
Primary
D0056232
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101227651
STATE LICENSE
VA
Enumeration date
08/03/2005
Last updated
05/23/2023
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