Individual
DR. BHANUMATHI KRISHNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3023 HAMAKER CT, SUITE 100, FAIRFAX, VA 22031-2222
(703) 641-9161
(703) 645-0493
Mailing address
3023 HAMAKER CT, SUITE 100, FAIRFAX, VA 22031-2222
(703) 641-9161
(703) 645-0493
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101266170
VA
207RC0000X
Cardiovascular Disease Physician
J3524
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008
CAREFIRST
—
01
—
00V373C96
MEDICARE OF VA
—
01
—
060059731
RAILROAD MEDICARE
—
01
—
216677
ANTHEM HEALTHKEEPERS PLUS
—
01
—
216678
ANTHEM
—
01
—
280446
MAMSI
—
01
—
4417390
AETNA HMO
—
01
—
541977219
TRICARE
—
05
—
5844428
—
VA
01
—
P00025883
RAILROAD MEDICARE
—
Enumeration date
09/03/2006
Last updated
12/15/2010
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