Provider Demographics
NPI:1083891659
Name:AHLUWALIA, JASPAL (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JASPAL
Middle Name:
Last Name:AHLUWALIA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 WILSON BLVD
Mailing Address - Street 2:950
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:20598-7198
Mailing Address - Country:US
Mailing Address - Phone:703-872-6629
Mailing Address - Fax:
Practice Address - Street 1:COMDT, USCG HQ (CG-1122), US COAST GUARD STOP 7907
Practice Address - Street 2:MARTIN LUTHER KING JR AVENUE SE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20598
Practice Address - Country:US
Practice Address - Phone:703-872-6629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-26
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01064841A2083P0500X, 2083P0901X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine