MEDICARE: ANNAPOORNA VARADA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	MD023209E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00747614	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518955186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNAPOORNA VARADA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 650782
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0782
Country	:	US
Telephone Number	:	888-709-4485
Fax Number	:	302-733-0854

Provider Business Practice Location Address
First Line	:	1088 W BALTIMORE PIKE
Second Line	:	STE 2407
City	:	MEDIA
State	:	PA
Zip	:	19063-5136
Country	:	US
Telephone Number	:	610-565-1808
Fax Number	:	877-329-2370

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	02/26/2013

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Directions to “ ANNAPOORNA VARADA M.D.” Practice Location

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