Individual
PRAKASH D ADAWADKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 DALE BLVD, DALE CITY, VA 22193-2243
(703) 670-0300
(703) 670-6759
Mailing address
4201 DALE BLVD, DALE CITY, VA 22193-2243
(703) 670-0300
(703) 670-6759
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101044728
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006708005
—
VA
01
—
10005
UNICARE-MEDICAID
VA
01
—
1639078
CIGNA
VA
01
—
451503
ANTHEM BLUE CROSS
VA
01
—
501200
NCPPO
VA
01
—
878906
MAMSI
VA
01
—
955166
UNITED HEALTHCARE
VA
01
—
B337-0001
CARE FIRST BLUE CROSS
VA
Enumeration date
05/23/2005
Last updated
05/18/2012
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