Individual
JEEVAN ERRABOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
503 BYRN ST STE 1, STE 1, CAMBRIDGE, MD 21613-1917
(410) 221-7770
(410) 221-7863
Mailing address
105 AURORA ST, CAMBRIDGE, MD 21613-1903
(410) 228-9515
(410) 228-3009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D69234
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418278200
—
MD
Enumeration date
06/25/2009
Last updated
03/20/2024
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