Individual
DR. MRIDULA BANAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 NORTH WASHINGTON STREET, FALLS CHURCH, VA 22046
(703) 536-1500
(703) 536-1395
Mailing address
2101 EAST JEFFERSON STREET, KAISER PERMANENTE, PPQA, 6 WEST,, ROCKVILLE, MD 20852
(301) 816-6660
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101233266
VA
208000000X
Pediatrics Physician
D0059466
MD
208000000X
Pediatrics Physician
MD33954
DC
Other
Enumeration date
01/31/2007
Last updated
11/23/2021
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