Provider Demographics
NPI:1649337767
Name:ANBARASAN, MALARMATHI THANGAVEL (MD)
Entity type:Individual
Prefix:DR
First Name:MALARMATHI
Middle Name:THANGAVEL
Last Name:ANBARASAN
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 1:19415 DEERFIELD AVE, SUITE 103
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-858-4900
Mailing Address - Fax:
Practice Address - Street 1:51 CATOCIN CIRCLE NE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-777-9510
Practice Address - Fax:703-554-1101
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059584207Q00000X
VA0101233048207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1649337767Medicaid