Healthcare Provider Details

I. General information

NPI: 1417867763
Provider Name (Legal Business Name): EQUILIBRIUM HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 GREENSBORO DR
MC LEAN VA
22102-3892
US

IV. Provider business mailing address

1775 WIEHLE AVE STE 400
RESTON VA
20190-5159
US

V. Phone/Fax

Practice location:
  • Phone: 703-637-8210
  • Fax: 800-246-3119
Mailing address:
  • Phone: 703-637-8210
  • Fax: 800-246-3119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. REEPA SHAH
Title or Position: FOUNDER/OWNER
Credential: MD
Phone: 703-637-8210