Provider Demographics
NPI:1083775571
Name:MAADHAVA ELLAURIE MD PC
Entity Type:Organization
Organization Name:MAADHAVA ELLAURIE MD PC
Other - Org Name:CAPITOL ALLERGY & ASTHMA CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAADHAVA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLAURIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-444-0817
Mailing Address - Street 1:21165 WHITFIELD PL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-7280
Mailing Address - Country:US
Mailing Address - Phone:703-444-0817
Mailing Address - Fax:703-444-0893
Practice Address - Street 1:21165 WHITFIELD PL
Practice Address - Street 2:SUITE 202
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-7280
Practice Address - Country:US
Practice Address - Phone:703-444-0817
Practice Address - Fax:703-444-0893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty