Provider Demographics
NPI:1487760690
Name:YARLAGADDA, ATMARAM (MD)
Entity type:Individual
Prefix:DR
First Name:ATMARAM
Middle Name:
Last Name:YARLAGADDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 STERNBERG AVE
Mailing Address - Street 2:
Mailing Address - City:FORT EUSTIS
Mailing Address - State:VA
Mailing Address - Zip Code:23604-1527
Mailing Address - Country:US
Mailing Address - Phone:757-314-7586
Mailing Address - Fax:
Practice Address - Street 1:502 STERNBERG AVE
Practice Address - Street 2:
Practice Address - City:FORT EUSTIS
Practice Address - State:VA
Practice Address - Zip Code:23604-1527
Practice Address - Country:US
Practice Address - Phone:757-314-7586
Practice Address - Fax:757-872-7211
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012386202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA087748MOtherSENTARA
VA7265863OtherAETNA
VA184125OtherANTHEM
VA010196639OtherFIRST HEALTH SERVICES COR
VA366237OtherMHN
VA142901Medicare UPIN