Individual
SUDAMA S THOLPADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10701 ROSEMARY DR, KAISER PERMANENTE MANASSAS MEDICAL CENTER, MANASSAS, VA 20109-7282
(703) 257-3000
(703) 257-3134
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101026010
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019751000
DEPT OF LABOR
—
01
—
0355933
UMWA
—
01
—
096769
BCBS OF VA
—
01
—
197510
BLACK LUNG
—
05
—
6045880
—
VA
05
—
64662307
—
KY
05
—
6466230700
—
KY
01
—
83745
SOUTHERN HEALTH SERVICES
—
01
—
8524
BCBS OF KY
—
Enumeration date
08/23/2005
Last updated
11/19/2011
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