Basic Information
| Provider Information | |||||||||
| NPI: | 1720603244 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAH SWARNAKAR | ||||||||
| FirstName: | ANKUR | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 ALABAMA AVE SOUTHEAST | ||||||||
| Address2: | 2ND FLOOR, SUITE 238 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022995334 | ||||||||
| FaxNumber: | 2025616953 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 ALABAMA AVE SOUTHEAST | ||||||||
| Address2: | 2ND FLOOR, SUITE 238 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022995334 | ||||||||
| FaxNumber: | 2025616953 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2020 | ||||||||
| LastUpdateDate: | 02/03/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 01/18/2022 | ||||||||
| NPIReactivationDate: | 02/03/2022 | ||||||||
| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.