Provider Demographics
NPI:1326058785
Name:ACHARYA, AJAYKUMAR ARJUNDEV (MD)
Entity Type:Individual
Prefix:
First Name:AJAYKUMAR
Middle Name:ARJUNDEV
Last Name:ACHARYA
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 1:4291 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:VA
Mailing Address - Zip Code:24301-7019
Mailing Address - Country:US
Mailing Address - Phone:540-980-1802
Mailing Address - Fax:540-980-1762
Practice Address - Street 1:4291 LEE HWY
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:VA
Practice Address - Zip Code:24301-7019
Practice Address - Country:US
Practice Address - Phone:540-980-1802
Practice Address - Fax:540-980-1762
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101045073207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6034071Medicaid
VA6034071Medicaid
VAB18778Medicare UPIN