Provider Demographics
NPI:1386133197
Name:SURATI, RUSHI KAMLESH (DO)
Entity type:Individual
Prefix:DR
First Name:RUSHI
Middle Name:KAMLESH
Last Name:SURATI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N WASHINGTON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3514
Mailing Address - Country:US
Mailing Address - Phone:703-522-1175
Mailing Address - Fax:571-665-6699
Practice Address - Street 1:500 N WASHINGTON ST STE 200
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3514
Practice Address - Country:US
Practice Address - Phone:703-522-1175
Practice Address - Fax:571-665-6699
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151011786207Q00000X
PAOS021497207Q00000X
VA0102209005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty