MEDICARE: RAJ VEMURI DPT

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	225100000X	Physical Therapist	25851	MD
2	225100000X	Physical Therapist	2305211830	VA

General Provider Information

NPI Number	:	1568823268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJ VEMURI DPT

Provider Business Mailing Address
First Line	:	43974 CHOPTANK TER
Second Line	:
City	:	ASHBURN
State	:	VA
Zip	:	20147-3939
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 N GLEBE RD STE GR2
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-3755
Country	:	US
Telephone Number	:	703-527-1700
Fax Number	:

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

Provider Enumeration Date	:	03/09/2016
Last Update Date	:	01/11/2023

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