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General NPI Number Information
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NPI Number | 1235380015
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Entity Type | Individual
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Provider Name | SUBRAMANIAN VARADARAJAN ANP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 7030 CARROLL AVE 2ND FLOOR
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City | TAKOMA PARK
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State | MD
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Zip | 20912-4430
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Country | US
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Telephone | 240-839-7133
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Fax |
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Provider Business Mailing Address
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Address Line | 10309 GLENMORE DR
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City | ADELPHI
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State | MD
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Zip | 20783-1202
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Country | US
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Telephone | 301-434-5590
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R120949
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License Number State | MD
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