Provider Demographics
NPI:1104929462
Name:SINHA, VIVEK P (MD)
Entity type:Individual
Prefix:
First Name:VIVEK
Middle Name:P
Last Name:SINHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3714 IVANHOE LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2156
Mailing Address - Country:US
Mailing Address - Phone:516-810-4662
Mailing Address - Fax:703-348-5603
Practice Address - Street 1:113 S WEST ST
Practice Address - Street 2:SUITE 204
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2858
Practice Address - Country:US
Practice Address - Phone:703-348-5603
Practice Address - Fax:703-348-5603
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0066720207Q00000X
VA0101255878207Q00000X
DCMD042074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1174568091OtherGROUP NPI - FORT WASHINGTON FAMILY MEDICAL CENTER
MD92408001-KR10MEOtherBCBS MARYLAND FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
DCB776-0033OtherBCBS NCA FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
IL036114462OtherIL STATE LICENSE #
MD1851473722OtherGROUP NPI - MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
MDD0066720OtherMD LICENSE
MD92408001-KR10MEOtherBCBS MARYLAND FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND