Provider Demographics
NPI:1245473719
Name:BANDARU, VARALAKSHMI V N (MD)
Entity type:Individual
Prefix:DR
First Name:VARALAKSHMI
Middle Name:V N
Last Name:BANDARU
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 1:1850 TOWN CENTER PKWY
Mailing Address - Street 2:RESTON HOSPITAL CENTER
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3204
Mailing Address - Country:US
Mailing Address - Phone:703-639-9513
Mailing Address - Fax:
Practice Address - Street 1:1850 TOWN CENTER PKWY
Practice Address - Street 2:RESTON HOSPITAL CENTER
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3204
Practice Address - Country:US
Practice Address - Phone:703-639-9513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD036923207U00000X
VA0101245904207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine