Provider Demographics
NPI:1780048264
Name:MALLAPAREDDI, ARUN NAG SANTHOSH
Entity type:Individual
Prefix:
First Name:ARUN NAG SANTHOSH
Middle Name:
Last Name:MALLAPAREDDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44335 PREMIER PLZ STE 230
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5052
Mailing Address - Country:US
Mailing Address - Phone:571-577-6806
Mailing Address - Fax:
Practice Address - Street 1:44335 PREMIER PLZ STE 23044335
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5051
Practice Address - Country:US
Practice Address - Phone:571-577-6806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.139042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine