Provider Demographics
NPI:1063437804
Name:NATHAN, ARUNA S (MD)
Entity type:Individual
Prefix:
First Name:ARUNA
Middle Name:S
Last Name:NATHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 GREENWAY CENTER DR STE 600
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-6704
Mailing Address - Country:US
Mailing Address - Phone:301-579-3465
Mailing Address - Fax:
Practice Address - Street 1:7501 GREENWAY CENTER DR STE 600
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-6704
Practice Address - Country:US
Practice Address - Phone:301-579-3465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053615207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1063437804OtherNPI IDENTIFIER
MD326300200Medicaid
G82431Medicare UPIN
MD133515ZA1XMedicare PIN