Provider Demographics
NPI:1588687263
Name:HINNARIA, ANIL R (MD)
Entity type:Individual
Prefix:DR
First Name:ANIL
Middle Name:R
Last Name:HINNARIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12486 ROSE PATH CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-6238
Mailing Address - Country:US
Mailing Address - Phone:571-594-1755
Mailing Address - Fax:703-218-8417
Practice Address - Street 1:10390 DEMOCRACY LN
Practice Address - Street 2:FAIRFAX ADS OUTPATIENT
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2522
Practice Address - Country:US
Practice Address - Phone:703-591-1393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012317242084P0800X
DCMD310162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
11180633OtherCAQH
VAH84088Medicare ID - Type Unspecified