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NPI Code Detail

MEDICARE: PALLAVI LAXMI SAMUDRALA MD

MEDICARE: PALLAVI LAXMI SAMUDRALA MD
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
1208D00000XGeneral Practice Physician0101287481VA

General Provider Information

NPI Number : 1881452001
Entity Type Code : Individual
Provider Name (Legal Business Name) : PALLAVI LAXMI SAMUDRALA MD
Provider Business Mailing Address
First Line : 751 THORNTON WAY APT 310
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-4428
Country : US
Telephone Number : 703-673-8980
Fax Number :
Provider Business Practice Location Address
First Line : ALEXANDER T. AUGUSTA MILITARY MEDICAL CENTER
Second Line : 9300 DEWITT LOOP
City : FORT BELVOIR
State : VA
Zip : 22060
Country : US
Telephone Number : 571-231-1803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2024
Last Update Date : 01/13/2026

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Directions to “ PALLAVI LAXMI SAMUDRALA MD” Practice Location

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