Healthcare Provider Details

I. General information

NPI: 1518194786
Provider Name (Legal Business Name): SRUJANA RALLABANDI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STANTONSBURG RD GRADUATE MEDICAL EDUCATION
GREENVILLE NC
27834-2818
US

IV. Provider business mailing address

1001 POTRERO AVE BLDG. 5, 6M
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-2335
  • Fax: 252-744-3811
Mailing address:
  • Phone: 628-206-8376
  • Fax: 628-206-7506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA151062
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA151062
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: