Individual
AHALYA PREMKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21351 RIDGETOP CIRCLE, STE 100, STERLING, VA 20166
(703) 641-9133
Mailing address
3015 WILLIAMS DRIVE, STE 200, FAIRFAX, VA 22031
(703) 641-9133
(703) 280-5098
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101044216
VA
2085R0202X
Diagnostic Radiology Physician
D0065070
MD
Other
Enumeration date
08/31/2006
Last updated
01/03/2008
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