Provider Demographics
NPI:1154557205
Name:KUMARAPPAN.M.D.INC,
Entity type:Organization
Organization Name:KUMARAPPAN.M.D.INC,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN
Authorized Official - Prefix:
Authorized Official - First Name:UMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMARAPPAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-766-0775
Mailing Address - Street 1:11211 WAPLES MILL ROAD
Mailing Address - Street 2:#150
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7414
Mailing Address - Country:US
Mailing Address - Phone:703-766-0775
Mailing Address - Fax:703-766-0776
Practice Address - Street 1:11211 WAPLES MILL RD
Practice Address - Street 2:#150
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7406
Practice Address - Country:US
Practice Address - Phone:703-766-0775
Practice Address - Fax:703-766-0776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012420772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA613322Medicare UPIN