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General NPI Number Information
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NPI Number | 1770504490
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Entity Type | Individual
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Provider Name | VIJAYENDRA RAO JALIGAM M.D
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 1945 OLD GALLOWS RD STE 210
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City | VIENNA
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State | VA
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Zip | 22182-3931
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Country | US
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Telephone | 571-470-6243
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Fax | 571-200-2617
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Provider Business Mailing Address
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Address Line | 1945 OLD GALLOWS RD STE 210
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City | VIENNA
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State | VA
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Zip | 22182-3931
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Country | US
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Telephone | 571-470-6243
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Fax | 571-200-2617
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 027061
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 027061
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2021040384
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101278527
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License Number State | VA
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