Provider Demographics
NPI:1992773659
Name:WALIA, SUNILA SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:SUNILA
Middle Name:SINGH
Last Name:WALIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUNILA
Other - Middle Name:
Other - Last Name:WALIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9601 BLACKWELL RD STE 260
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6487
Mailing Address - Country:US
Mailing Address - Phone:301-610-0663
Mailing Address - Fax:301-610-5420
Practice Address - Street 1:9601 BLACKWELL RD STE 260
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6487
Practice Address - Country:US
Practice Address - Phone:301-610-0663
Practice Address - Fax:301-610-5420
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD30929207N00000X
VA0101246791207N00000X
MDD63622207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC027249500Medicaid
VA005900751Medicaid
DC007422M83Medicare UPIN
H34204Medicare UPIN
MD775503100Medicare ID - Type Unspecified