Healthcare Provider Details

I. General information

NPI: 1588693337
Provider Name (Legal Business Name): JOYSON KARAKUNNEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 N. GEORGE MASON DR. SUITE 115
ARLINGTON VA
22205-3601
US

IV. Provider business mailing address

18606 HARVEST SCENE CT
BOYDS MD
20841-4374
US

V. Phone/Fax

Practice location:
  • Phone: 703-243-1310
  • Fax: 703-243-0128
Mailing address:
  • Phone: 301-641-6063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number0101237665
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: