1255906616 NPI number — RUPINDER KAUR BAHNIWAL MBBS

Table of content: RUPINDER KAUR BAHNIWAL MBBS (NPI 1255906616)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255906616 NPI number — RUPINDER KAUR BAHNIWAL MBBS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAHNIWAL
Provider First Name:
RUPINDER
Provider Middle Name:
KAUR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MBBS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255906616
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
11/23/2022
NPI Reactivation Date:
12/12/2022

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
INOVA FAIRFAX MEDICAL CAMPUS, GME CARDIOLOGY FELLOWSHIP
Provider Second Line Business Mailing Address:
SUPPORT SERVICES BLDG, 3300 GALLOWS ROAD
Provider Business Mailing Address City Name:
FALLS CHURCH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-446-7934
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
INOVA FAIRFAX MEDICAL CAMPUS, GME CARDIOLOGY FELLOWSHIP
Provider Second Line Business Practice Location Address:
SUPPORT SERVICES BLDG, 3300 GALLOWS ROAD
Provider Business Practice Location Address City Name:
FALLS CHURCH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-776-2626
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/26/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)