Provider Demographics
NPI:1962488056
Name:SURI, ROHIT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROHIT
Middle Name:
Last Name:SURI
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 1:3903 FAIR RIDGE DR STE 209
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2944
Mailing Address - Country:US
Mailing Address - Phone:709-865-6490
Mailing Address - Fax:703-865-6492
Practice Address - Street 1:3903 FAIR RIDGE DR
Practice Address - Street 2:SUITE 219
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2943
Practice Address - Country:US
Practice Address - Phone:709-865-6490
Practice Address - Fax:703-865-6492
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85329207Q00000X
VA0101246943207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265197100Medicaid
VAVAA102542Medicare PIN
VA321085YWAUMedicare PIN
E8209YMedicare ID - Type Unspecified