MEDICARE: DR. MALLEESWARI NELLORE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	0101268824	VA

General Provider Information

NPI Number	:	1174651848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MALLEESWARI NELLORE M.D.

Provider Business Mailing Address
First Line	:	11608 BROCKMAN LN
Second Line	:
City	:	GREAT FALLS
State	:	VA
Zip	:	22066-1138
Country	:	US
Telephone Number	:	888-464-2466
Fax Number	:

Provider Business Practice Location Address
First Line	:	11608 BROCKMAN LN
Second Line	:
City	:	GREAT FALLS
State	:	VA
Zip	:	22066-1138
Country	:	US
Telephone Number	:	888-464-2466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	10/27/2020

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1528221116 — DR. JENNA T PULKKA D.M.D
Practice Location Address:

568 LISBON ST , SUITE 1
LISBON FALLS, ME
04252-1138

Practice Phone: 207-407-4301
Practice Fax:

1083003255 — LISBON FAMILY DENTAL CARE
Practice Location Address:

568 LISBON ST , SUITE 1
LISBON FALLS, ME
04252-1138

Practice Phone: 207-407-4301
Practice Fax:

1033726013 — MS. LEILANI HELENE KNAPP RN
Practice Location Address:

4093 SENECA PKWY
NIAGARA FALLS, NY
14304-1138

Practice Phone: 716-912-8055
Practice Fax:

1720679707 — MARIAH BRETON RDH
Practice Location Address:

568 LISBON ST
LISBON FALLS, ME
04252-1138

Practice Phone: 207-212-7677
Practice Fax:

1760263883 — MOUNTAIN VIEW PHYSIATRY
Practice Location Address:

1138 E POLELINE AVE
POST FALLS, ID
83854-6150

Practice Phone: 208-777-5511
Practice Fax: 724-426-8936

Directions to “ DR. MALLEESWARI NELLORE M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.