Individual
JEYANDRA SELVAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1840 AMHERST ST, WINCHESTER, VA 22601-2808
(540) 536-2270
(540) 536-7847
Mailing address
136 LINDEN DR, SUITE 104, WINCHESTER, VA 22601-6900
(540) 678-3588
(540) 678-9025
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101258196
VA
208M00000X
Hospitalist Physician
Primary
0101258196
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01545523
RR MEDICARE
VA
Enumeration date
09/27/2012
Last updated
11/04/2016
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