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Organization
POTOMAC HEALTH SERVICES,LLC
Active
Organization
POTOMAC HEALTH SERVICES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMUNA D RAJU MD (PSYCHAITRIST)
(703) 861-8722
Entity
Organization
Contact information
Practice address
611 S CARLIN SPRINGS RD, SUITE # 501, ARLINGTON, VA 22204-1064
(703) 861-8722
(571) 366-2056
Mailing address
6508 DEARBORN DR, FALLS CHURCH, VA 22044-1115
(703) 658-8722
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0101236470
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00359381
MEDICARE RAILROAD
—
Enumeration date
06/30/2007
Last updated
12/21/2011
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