Provider Demographics
NPI:1134487127
Name:CHAGALAMARRI, SHWETHA (DO)
Entity Type:Individual
Prefix:
First Name:SHWETHA
Middle Name:
Last Name:CHAGALAMARRI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SHWETHA
Other - Middle Name:
Other - Last Name:CHAGALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3300 GALLOWS RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3307
Mailing Address - Country:US
Mailing Address - Phone:703-776-4001
Mailing Address - Fax:703-776-7113
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:703-776-4001
Practice Address - Fax:703-776-7113
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0082012208M00000X
VA0102205168208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist