Healthcare Provider Details

I. General information

NPI: 1659281491
Provider Name (Legal Business Name): O'BRYAN & GORRELL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 CHURCH ST NW STE 201
VIENNA VA
22180-4536
US

IV. Provider business mailing address

111 CHURCH ST NW STE 201
VIENNA VA
22180-4536
US

V. Phone/Fax

Practice location:
  • Phone: 202-335-8105
  • Fax: 202-428-0470
Mailing address:
  • Phone: 202-335-8105
  • Fax: 202-428-0470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHUCHITA GORRELL
Title or Position: CLINICIAN
Credential: NP
Phone: 202-335-8105