Provider Demographics
NPI:1194701805
Name:PAL, JOGINDER (MD)
Entity type:Individual
Prefix:DR
First Name:JOGINDER
Middle Name:
Last Name:PAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:289 INDEPENDENCE BLVD
Mailing Address - Street 2:PEMBROKE 3 SUITE 221
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462
Mailing Address - Country:US
Mailing Address - Phone:757-498-9320
Mailing Address - Fax:757-498-9321
Practice Address - Street 1:289 INDEPENDENCE BLVD
Practice Address - Street 2:PEMBROKE 3 SUITE 221
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-498-9320
Practice Address - Fax:757-498-9321
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010337412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA184931OtherANTHEM
VA088157MOtherSENTARA
VA184177OtherANTHEM
VA132591OtherTRICARE
B09019Medicare UPIN