Provider Demographics
NPI:1992200042
Name:GULATI, AMAR RAJ (DPM)
Entity Type:Individual
Prefix:
First Name:AMAR
Middle Name:RAJ
Last Name:GULATI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:611 S CARLIN SPRINGS RD STE 508
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1088
Mailing Address - Country:US
Mailing Address - Phone:703-566-0803
Mailing Address - Fax:571-867-9905
Practice Address - Street 1:611 S CARLIN SPRINGS RD STE 508
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1088
Practice Address - Country:US
Practice Address - Phone:703-566-0803
Practice Address - Fax:571-867-9905
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.004042213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery