Provider Demographics
NPI:1407617442
Name:BALUSU, RAJA MOUNIKA (MD)
Entity Type:Individual
Prefix:MRS
First Name:RAJA MOUNIKA
Middle Name:
Last Name:BALUSU
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:PULMONARY CLINIC, ROOM 1030, CHILDREN'S NATIONAL HOSPIT
Mailing Address - Street 2:111 MICHIGAN AVENUE, NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010
Mailing Address - Country:US
Mailing Address - Phone:888-884-2327
Mailing Address - Fax:
Practice Address - Street 1:PULMONARY CLINIC, ROOM 1030, CHILDREN'S NATIONAL HOSPIT
Practice Address - Street 2:111 MICHIGAN AVENUE, NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:888-884-2327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMTL6001015722080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology