Individual
MRS. JAYASREE PATLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10100 FAIRFAX BLVD, FAIRFAX, VA 22030-2000
(703) 679-1876
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101230586
VA
207QA0505X
Adult Medicine Physician
0101230586
VA
Other
Enumeration date
01/15/2007
Last updated
10/24/2023
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