Healthcare Provider Details

I. General information

NPI: 1235700261
Provider Name (Legal Business Name): SOHAN WARUSHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 MEDICAL CENTER DR
ROCKVILLE MD
20850-3357
US

IV. Provider business mailing address

11870 GRAND PARK AVE APT 810
NORTH BETHESDA MD
20852-8700
US

V. Phone/Fax

Practice location:
  • Phone: 215-707-4085
  • Fax: 215-707-5978
Mailing address:
  • Phone: 240-620-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD0104238
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT222692
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: