Provider Demographics
NPI:1124032057
Name:JALLA, GIRJA R (MD)
Entity Type:Individual
Prefix:DR
First Name:GIRJA
Middle Name:R
Last Name:JALLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 S CARLIN SPRINGS RD STE 509
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1088
Mailing Address - Country:US
Mailing Address - Phone:703-820-6060
Mailing Address - Fax:
Practice Address - Street 1:611 S CARLIN SPRINGS RD STE 509
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1088
Practice Address - Country:US
Practice Address - Phone:703-820-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-036266207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine