Provider Demographics
NPI:1871548255
Name:SUNKARA, VIJAYA L (MD)
Entity type:Individual
Prefix:
First Name:VIJAYA
Middle Name:L
Last Name:SUNKARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:571-291-6131
Mailing Address - Fax:571-291-6135
Practice Address - Street 1:21170 ASHBY PONDS BLVD
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6128
Practice Address - Country:US
Practice Address - Phone:571-291-6131
Practice Address - Fax:571-291-6135
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101228282207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI5881498Medicaid
VA110008497Medicare ID - Type Unspecified
VI5881498Medicaid