Provider Demographics
NPI:1285668491
Name:BUDAMPATI, SUNEETHA (MD)
Entity Type:Individual
Prefix:
First Name:SUNEETHA
Middle Name:
Last Name:BUDAMPATI
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 1:11350 MCCORMICK RD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, STE.501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031
Mailing Address - Country:US
Mailing Address - Phone:703-738-4332
Mailing Address - Fax:703-642-1876
Practice Address - Street 1:2800 S SHIRLINGTON RD STE 102
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-3603
Practice Address - Country:US
Practice Address - Phone:703-738-4332
Practice Address - Fax:703-642-1876
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00629452081P2900X
VA0101238159208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD002904N19Medicare PIN