Individual
MAHADEVAPPA K HUNASIKATTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
14163 ROBERT PARIS CT STE B, CHANTILLY, VA 20151-4241
(703) 817-2641
(310) 602-6593
Mailing address
13256 MIDDLETON FARM LN, OAK HILL, VA 20171-3849
(703) 573-9212
(703) 573-9219
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
0101058372
VA
207RP1001X
Pulmonary Disease Physician
0101058372
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110205335
RAIL ROAD MEDICARE
VA
01
—
285910
ANTHEM
VA
01
—
321846
MAMSI LIFE & HEALTH
VA
01
—
54077
AMERIGROUP
VA
01
—
541973937
TAX I.D.
VA
05
—
5876931
—
VA
01
—
8268-0001
CAREFIRST BLUESHIELD
DC
01
—
9605223
GHI
VA
Enumeration date
07/01/2006
Last updated
08/30/2024
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