Provider Demographics
NPI:1689773731
Name:VARMA, SUPRIYA (MD, FACOG)
Entity Type:Individual
Prefix:DR
First Name:SUPRIYA
Middle Name:
Last Name:VARMA
Suffix:
Gender:F
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 TOWN CENTER DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5896
Mailing Address - Country:US
Mailing Address - Phone:703-352-3344
Mailing Address - Fax:703-796-1918
Practice Address - Street 1:1860 TOWN CENTER DR
Practice Address - Street 2:SUITE 240
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5896
Practice Address - Country:US
Practice Address - Phone:703-352-3344
Practice Address - Fax:703-796-1918
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057579174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH15783Medicare UPIN