| Chantilly Family Medicine Llc | |
|
14113 Robert Paris Ct Chantilly VA 20151-4200 | |
| (703) 956-6757 | |
| (855) 359-2261 |
| Full Name | Chantilly Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 14113 Robert Paris Ct, Chantilly, Virginia |
| Authorized Official Name and Position | Kanika Govil (PRESIDENT) |
| Authorized Official Contact | 7035998463 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chantilly Family Medicine Llc 14113 Robert Paris Ct Chantilly VA 20151-4200 Ph: (039) 566-7577 | Chantilly Family Medicine Llc 14113 Robert Paris Ct Chantilly VA 20151-4200 Ph: (703) 956-6757 |
| NPI Number | 1306106182 |
|---|---|
| Provider Enumeration Date | 05/25/2012 |
| Last Update Date | 08/31/2023 |
| Medicare PECOS PAC ID | 0547424772 |
|---|---|
| Medicare Enrollment ID | O20120619000346 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306106182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101242454 (Virginia) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Kanika Govil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215026703 PECOS PAC ID: 8426050063 Enrollment ID: I20070209000449 |
| Provider Name | Sharayu Sawant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417160144 PECOS PAC ID: 2769507847 Enrollment ID: I20100913000860 |
| Provider Name | Asma Islam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184853806 PECOS PAC ID: 2961541131 Enrollment ID: I20180918000432 |
| Provider Name | Simranjit Gulati |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578198289 PECOS PAC ID: 6406263276 Enrollment ID: I20210323000011 |
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