Organization
JEEVAN ERRABOLU MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS KIRBY (CREDENTIALING ADMINISTRATOR)
(301) 565-2250
Entity
Organization
Contact information
Practice address
11130 SUNRISE VALLEY DR STE 120, RESTON, VA 20191-5474
(571) 376-1135
Mailing address
11130 SUNRISE VALLEY DR STE 120, RESTON, VA 20191-5474
(571) 376-1135
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
02/14/2025
Last updated
02/14/2025
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