Provider Demographics
NPI:1164643300
Name:VEERAPALLI, VENKATESWAR R (MD)
Entity Type:Individual
Prefix:
First Name:VENKATESWAR
Middle Name:R
Last Name:VEERAPALLI
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 1:800 UTTERBACK STORE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-1538
Mailing Address - Country:US
Mailing Address - Phone:703-635-6121
Mailing Address - Fax:540-727-8882
Practice Address - Street 1:21001 SYCOLIN RD STE 180
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4074
Practice Address - Country:US
Practice Address - Phone:703-687-4363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD437637207RH0000X
VA0101058298207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG87536Medicare UPIN
VAC09687Medicare PIN
DC492191Medicare PIN
VA00W775V01Medicare PIN