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General NPI Number Information
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NPI Number | 1912936170
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Entity Type | Individual
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Provider Name | MAHADEVAPPA K HUNASIKATTI M.D
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Gender | Male
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 14163 ROBERT PARIS CT STE B
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City | CHANTILLY
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State | VA
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Zip | 20151-4241
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Country | US
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Telephone | 703-817-2641
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Fax | 310-602-6593
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Provider Business Mailing Address
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Address Line | 13256 MIDDLETON FARM LN
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City | OAK HILL
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State | VA
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Zip | 20171-3849
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Country | US
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Telephone | 703-573-9212
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Fax | 703-573-9219
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 0101058372
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 0101058372
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License Number State | VA
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