Provider Demographics
NPI:1780843144
Name:KOLLI, APARNA H (MD)
Entity Type:Individual
Prefix:DR
First Name:APARNA
Middle Name:H
Last Name:KOLLI
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 1:1101 SAM PERRY BLVD
Mailing Address - Street 2:STE 219
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4465
Mailing Address - Country:US
Mailing Address - Phone:540-741-2865
Mailing Address - Fax:540-741-2868
Practice Address - Street 1:1101 SAM PERRY BLVD STE 219
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4465
Practice Address - Country:US
Practice Address - Phone:540-741-2865
Practice Address - Fax:540-741-2868
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101267914208600000X, 2086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP01130911OtherRAILROAD MEDICARE
NJ0247529Medicaid
NJ800755P3VMedicare PIN