Provider Demographics
NPI:1003997479
Name:ARUN, ANURADHA A (MD)
Entity Type:Individual
Prefix:
First Name:ANURADHA
Middle Name:A
Last Name:ARUN
Suffix:
Gender:F
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 1708
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20915-1708
Mailing Address - Country:US
Mailing Address - Phone:301-593-9800
Mailing Address - Fax:301-593-1061
Practice Address - Street 1:9801 GEORGIA AVE
Practice Address - Street 2:SUITE 224
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5276
Practice Address - Country:US
Practice Address - Phone:301-593-9800
Practice Address - Fax:301-593-1061
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0057630207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD699207200Medicaid
MDG01555A01Medicare PIN
DCG01555A01Medicare PIN
MD699207200Medicaid