Provider Demographics
NPI:1992145700
Name:HUNDAL, SAHANA
Entity type:Individual
Prefix:
First Name:SAHANA
Middle Name:
Last Name:HUNDAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SAHANA
Other - Middle Name:
Other - Last Name:DONGERKERY
Other - Suffix:
Other - Last Name Type:Former Name
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:703-709-6116
Mailing Address - Fax:703-904-0497
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
Practice Address - Country:US
Practice Address - Phone:703-709-6116
Practice Address - Fax:703-904-0497
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT203123207R00000X
VA0101264674207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine