Provider Demographics
NPI:1386263549
Name:SHANKAR, ANJALI (MD)
Entity type:Individual
Prefix:
First Name:ANJALI
Middle Name:
Last Name:SHANKAR
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 1:12007 SUNRISE VALLEY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3446
Mailing Address - Country:US
Mailing Address - Phone:703-215-8571
Mailing Address - Fax:
Practice Address - Street 1:12007 SUNRISE VALLEY DR STE 300
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3446
Practice Address - Country:US
Practice Address - Phone:703-215-8571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012816342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry