Basic Information
Provider Information
NPI: 1346472503
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BHOGAL
FirstName: HARJIT
MiddleName: KAUR
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7605 FOREST AVE
Address2: STE 211
City: RICHMOND
State: VA
PostalCode: 232294940
CountryCode: US
TelephoneNumber: 8042823114
FaxNumber: 8042859723
Practice Location
Address1: 14955 SHADY GROVE RD
Address2: SUITE 150
City: ROCKVILLE
State: MD
PostalCode: 208508700
CountryCode: US
TelephoneNumber: 3013403252
FaxNumber: 3013401423
Other Information
ProviderEnumerationDate: 08/20/2009
LastUpdateDate: 09/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X0101248446VAY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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