Provider Demographics
NPI:1306025382
Name:ANU N. RALAPATI, MD PC
Entity type:Organization
Organization Name:ANU N. RALAPATI, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ANURADHA
Authorized Official - Middle Name:NEELAM
Authorized Official - Last Name:RALAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-393-8187
Mailing Address - Street 1:3930 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4738
Mailing Address - Country:US
Mailing Address - Phone:703-591-9320
Mailing Address - Fax:703-591-9321
Practice Address - Street 1:3930 WALNUT ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4738
Practice Address - Country:US
Practice Address - Phone:703-591-9320
Practice Address - Fax:703-591-9321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054971207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
285160OtherANTHEM BCBS
5914OtherCAREFIRST BCBS
VA5847044Medicaid
38001514OtherRAILROAD MEDICARE
G50252Medicare UPIN
DCG01377Medicare PIN
VA11007745Medicare PIN