Provider Demographics
NPI:1922290873
Name:RAJU, JAMUNA D (MD)
Entity Type:Individual
Prefix:
First Name:JAMUNA
Middle Name:D
Last Name:RAJU
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 1:6508 DEARBORN DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-1115
Mailing Address - Country:US
Mailing Address - Phone:703-861-8722
Mailing Address - Fax:703-485-1179
Practice Address - Street 1:611 S CARLIN SPRINGS RD
Practice Address - Street 2:SUITE # 501
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1064
Practice Address - Country:US
Practice Address - Phone:703-861-8722
Practice Address - Fax:703-485-1179
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2008-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012364702084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DF3642OtherMEDICARE RAILROAD
VAI25348OtherUPIN
VAI25348OtherUPIN