Provider Demographics
NPI:1932216330
Name:PRAKASH D. ADAWADKAR, M.D., P.C.
Entity Type:Organization
Organization Name:PRAKASH D. ADAWADKAR, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRAKASH
Authorized Official - Middle Name:D
Authorized Official - Last Name:ADAWADKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-670-0300
Mailing Address - Street 1:4201 DALE BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-2243
Mailing Address - Country:US
Mailing Address - Phone:703-670-0300
Mailing Address - Fax:703-670-6759
Practice Address - Street 1:4201 DALE BLVD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-2243
Practice Address - Country:US
Practice Address - Phone:703-670-0300
Practice Address - Fax:703-670-6759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty