Provider Demographics
NPI:1720068992
Name:CHARY, BEJJENKI S (MD)
Entity Type:Individual
Prefix:
First Name:BEJJENKI
Middle Name:S
Last Name:CHARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 GATEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-2027
Mailing Address - Country:US
Mailing Address - Phone:703-765-4665
Mailing Address - Fax:
Practice Address - Street 1:2616 SHERWOOD HALL LN
Practice Address - Street 2:SUITE 303
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3100
Practice Address - Country:US
Practice Address - Phone:703-799-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-22
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233071207R00000X
DCMD30938207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCH09980Medicare UPIN