Provider Demographics
NPI:1720287337
Name:MATHURIA, ADHUNA C (MD)
Entity type:Individual
Prefix:DR
First Name:ADHUNA
Middle Name:C
Last Name:MATHURIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ADHUNA
Other - Middle Name:
Other - Last Name:CHHABRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:24600 MILLSTREAM DR STE 430
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-3512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24600 MILLSTREAM DR STE 430
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-3512
Practice Address - Country:US
Practice Address - Phone:703-327-3300
Practice Address - Fax:703-542-6785
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246174207RA0201X
MDD69776207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD036184400Medicaid
MD036184400Medicaid