Individual
SHOBHA RANI NALLURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4730 PUDDLEDOCK RD, SUITE 100, PRINCE GEORGE, VA 23875-1237
(804) 452-3850
(804) 541-7585
Mailing address
7202 GLEN FOREST DR, C/O VIRGINIA CANCER INSTITUTE SUITE 200, RICHMOND, VA 23226-3781
(804) 673-0134
(804) 673-1796
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
0101250289
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C01120
MEDICARE GROUP PTAN
VA
Enumeration date
09/15/2007
Last updated
02/22/2024
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