Provider Demographics
NPI:1003851890
Name:DUA, PUNKAJ K (MD)
Entity Type:Individual
Prefix:
First Name:PUNKAJ
Middle Name:K
Last Name:DUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-689-1110
Mailing Address - Fax:540-689-1119
Practice Address - Street 1:2010 HEALTH CAMPUS DR
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8679
Practice Address - Country:US
Practice Address - Phone:540-689-1110
Practice Address - Fax:540-689-1119
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235805208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1003851890Medicaid
WV3810005703Medicaid
I24919Medicare UPIN
VA197999OtherBCBS OF VA
PA822990OtherFIRST PRIORITY
VA010287201Medicaid
PA1021367900001Medicaid
PA126083Medicare PIN
VA010509P82Medicare PIN