Provider Demographics
NPI:1528091683
Name:DAYAL, KIREN MACON (DO)
Entity type:Individual
Prefix:DR
First Name:KIREN
Middle Name:MACON
Last Name:DAYAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:8191 STRAWBERRY LN
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1031
Mailing Address - Country:US
Mailing Address - Phone:703-493-0404
Mailing Address - Fax:
Practice Address - Street 1:8191 STRAWBERRY LN
Practice Address - Street 2:SUITE 6
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1031
Practice Address - Country:US
Practice Address - Phone:703-493-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS9302207Q00000X
GA058664207Q00000X
VA0102202742207Q00000X
MDH0071658207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I69686Medicare UPIN