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Individual

DR. ATHREYA TATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
14139 POTOMAC MILLS RD, WOODBRIDGE, VA 22192-4644
(703) 359-7878
Mailing address
14139 POTOMAC MILLS RD, WOODBRIDGE, VA 22192-4644
(703) 359-7878

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101272188
VA

Other

Enumeration date
06/06/2018
Last updated
09/30/2021
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