Provider Demographics
NPI:1184081820
Name:INDUS PSYCHIATRIC SERVICES
Entity type:Organization
Organization Name:INDUS PSYCHIATRIC SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDHYA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJASEKHARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-766-9025
Mailing Address - Street 1:203 BILL SOURS DR
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-3364
Mailing Address - Country:US
Mailing Address - Phone:443-766-9025
Mailing Address - Fax:866-362-7725
Practice Address - Street 1:3057 GEORGE WASHINGTON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072-3300
Practice Address - Country:US
Practice Address - Phone:757-922-3085
Practice Address - Fax:866-362-7725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012465202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1962653402Medicaid
VA1184081820Medicaid