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Individual

DR. REENA RAO BOMMASANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
13168 CENTERPOINTE WAY STE 101, WOODBRIDGE, VA 22193-5287
(703) 730-2000
(703) 730-6767
Mailing address
13168 CENTERPOINTE WAY STE 101, WOODBRIDGE, VA 22193-5287
(703) 730-2000
(703) 730-6767

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101236174
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010314216
VA
05
010314241
VA
05
1427061381
VA
Enumeration date
08/14/2006
Last updated
08/10/2023
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