Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 0102202353 | VA |
N | 2080P0202X | Pediatric Cardiologist | H68910 | MD |
NPI | 1184870685 |
---|---|
Provider Name | Dr. Harish Sitaram Rudra |
First Address | Falls Church, VA 22042-3307 |
Second Address | Falls Church, VA 22042-3307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2008 |
Last Update Date | 15/07/2021 |