Provider Demographics
NPI:1982843421
Name:ANNU NARAYANAN PULLARKAT, PLLC
Entity Type:Organization
Organization Name:ANNU NARAYANAN PULLARKAT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.B.B.S/M.D
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNU
Authorized Official - Middle Name:NARAYANAN
Authorized Official - Last Name:PULLARKAT
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS/MD
Authorized Official - Phone:703-205-0423
Mailing Address - Street 1:2188 AMBER MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-5320
Mailing Address - Country:US
Mailing Address - Phone:703-205-0423
Mailing Address - Fax:703-992-6747
Practice Address - Street 1:2188 AMBER MEADOWS DR
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-5320
Practice Address - Country:US
Practice Address - Phone:703-205-0423
Practice Address - Fax:703-992-6747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-06
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101243831207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1982843421Medicaid