Provider Demographics
NPI:1144519190
Name:KANAL, MONICA (DO)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:KANAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SULLIVAN ST STE A
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2737
Mailing Address - Country:US
Mailing Address - Phone:540-216-3393
Mailing Address - Fax:226-785-0426
Practice Address - Street 1:50 SULLIVAN ST STE A
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2737
Practice Address - Country:US
Practice Address - Phone:402-163-3935
Practice Address - Fax:540-216-7301
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDO034400207R00000X
VA0102203439207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty