Provider Demographics
NPI:1811965874
Name:SARMA, AMITABHA (MD)
Entity type:Individual
Prefix:
First Name:AMITABHA
Middle Name:
Last Name:SARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3040 WILLIAMS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4618
Mailing Address - Country:US
Mailing Address - Phone:571-350-8400
Mailing Address - Fax:703-940-8697
Practice Address - Street 1:44035 RIVERSIDE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8260
Practice Address - Country:US
Practice Address - Phone:703-208-3155
Practice Address - Fax:703-724-7503
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101238072207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA248921OtherKAISER
VA541795091OtherUNTIED HEALTHCARE
VA161790-2134683OtherMAMSI/OP CHOICE/ALLIANCE
VA541795091OtherFX CTY COMM HEALTH
VA7884418OtherAETNA PPO
VA010185947Medicaid
VA176696OtherANTHEM/TRIGON
VA541795091OtherPHCS PPO/POS
VA541795091OtherTRICARE
VA0870-821RFAOtherBCBS NCA-CAREFIRST
VA379344OtherAETNA HMO
VA541795091OtherCHOICE CARE
VA161790-2134683OtherMAMSI/OP CHOICE/ALLIANCE
TX157404801Medicaid
VA007538F65Medicare PIN
VA7884418OtherAETNA PPO
VA379344OtherAETNA HMO
VA017166F90Medicare PIN