| Doctor Name: | DR. PREMAKUMARI MURALIDURAISAMI |
| NPI Number: | 1659609766 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 0101243225 |
| Business Practice Address: | 6049 Leesburg Pike 104 Falls Church, VA - 220412221 |
| Business Phone Number: | 7039333073 |
| Business Fax Number: | 7039333043 |
| Mailing Address: | 6049 Leesburg Pike, 104 FALLS CHURCH |
| State: | VA |
| Postal Code: | 220412221 |
| Phone Number: | 7039333073 |
| Fax Number: | 7039333043 |
| NPI Enumeration Date: | 12/01/2009 |
| NPI Last Update Date: | 12/01/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101243225 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |