Venna, Suraj S

Venna, Suraj S is an individual health care provider with primary practice located at 8081 Innovation Park Dr , Fairfax VA 22031-4867. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Venna, Suraj S can be contacted via phone (571) 472-4724.

Contact Information

Primary practice address
8081 Innovation Park Dr Fairfax VA 22031-4867
Phone: (571) 472-4724
Fax: (571) 472-0241
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 218355 Massachusetts
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 0101255078 Virginia

Profile Details

NPI number 1366433302
LBN Legal business name Venna, Suraj S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Nov 27th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366433302 NPPES
Massachusetts MEDICAID 2100550

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