Provider Demographics
NPI:1215966403
Name:KAUR, NAVLEEN (MD)
Entity type:Individual
Prefix:
First Name:NAVLEEN
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11901 BARON CAMERON AVE
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5892
Mailing Address - Country:US
Mailing Address - Phone:703-464-6480
Mailing Address - Fax:703-464-6482
Practice Address - Street 1:11901 BARON CAMERON AVE
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5892
Practice Address - Country:US
Practice Address - Phone:703-464-6480
Practice Address - Fax:703-464-6482
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236203207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010077265Medicaid
VAI09094Medicare UPIN
004956B15Medicare ID - Type Unspecified