Healthcare Provider Details

I. General information

NPI: 1508835067
Provider Name (Legal Business Name): JEY A MARAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JEYARAMAN ARULTHURIMARAN M.D.

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9450 INNOVATION DR
MANASSAS VA
20110-2214
US

IV. Provider business mailing address

3040 WILLIAMS DR STE 100
FAIRFAX VA
22031-4618
US

V. Phone/Fax

Practice location:
  • Phone: 571-222-2200
  • Fax: 571-222-2202
Mailing address:
  • Phone: 571-350-8400
  • Fax: 571-222-2202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number0101054703
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number0101054703
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number0101054703
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: