Provider Demographics
NPI:1912936170
Name:HUNASIKATTI, MAHADEVAPPA K (MD)
Entity Type:Individual
Prefix:
First Name:MAHADEVAPPA
Middle Name:K
Last Name:HUNASIKATTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13256 MIDDLETON FARM LN
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20171-3849
Mailing Address - Country:US
Mailing Address - Phone:703-573-9212
Mailing Address - Fax:703-573-9219
Practice Address - Street 1:2826 OLD LEE HWY
Practice Address - Street 2:STE 330
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4347
Practice Address - Country:US
Practice Address - Phone:703-955-1996
Practice Address - Fax:703-563-6090
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058372207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC8268-0001OtherCAREFIRST BLUESHIELD
VA110205335OtherRAIL ROAD MEDICARE
VA321846OtherMAMSI LIFE & HEALTH
VA54077OtherAMERIGROUP
VA9605223OtherGHI
VA541973937OtherTAX I.D.
VA285910OtherANTHEM
VA5876931Medicaid