Provider Demographics
NPI:1548555998
Name:SRINIVAS, SHUBHA VENKATESH (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SHUBHA
Middle Name:VENKATESH
Last Name:SRINIVAS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:SHUBHA
Other - Middle Name:
Other - Last Name:VENKATESH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:3289 WOODBURN RD STE 350
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-7357
Mailing Address - Country:US
Mailing Address - Phone:703-641-8616
Mailing Address - Fax:
Practice Address - Street 1:3289 WOODBURN RD STE 350
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-7357
Practice Address - Country:US
Practice Address - Phone:703-641-8616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255218207RC0200X, 207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine