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General NPI Number Information
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NPI Number | 1114119831
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Entity Type | Individual
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Provider Name | MADHURI V VALLABHANENI M.D
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Gender | Female
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 44045 RIVERSIDE PKWY
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City | LEESBURG
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State | VA
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Zip | 20176-5101
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Country | US
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Telephone | 703-858-6000
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Fax | 703-858-6900
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Provider Business Mailing Address
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Address Line | 44045 RIVERSIDE PKWY INTERNAL MEDICINE DEPT
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City | LEESBURG
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State | VA
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Zip | 20176-5101
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Country | US
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Telephone | 703-858-8074
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Fax | 703-858-6797
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101242257
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101242257
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License Number State | VA
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