Provider Demographics
NPI:1104987049
Name:THATHAGARI, NEERAJA (MD)
Entity type:Individual
Prefix:
First Name:NEERAJA
Middle Name:
Last Name:THATHAGARI
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:NOVA MEDICAL SERVICES, PLLC
Mailing Address - Street 2:P.O.BOX 734
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20122
Mailing Address - Country:US
Mailing Address - Phone:703-961-1119
Mailing Address - Fax:703-961-1159
Practice Address - Street 1:43130 AMBERWOOD PLZ STE 240
Practice Address - Street 2:
Practice Address - City:SOUTH RIDING
Practice Address - State:VA
Practice Address - Zip Code:20152-4110
Practice Address - Country:US
Practice Address - Phone:703-961-1119
Practice Address - Fax:703-961-1159
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237990207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine