Provider Demographics
NPI:1821071028
Name:VELURI, SAVITHRI-CHANDANA (VA)
Entity Type:Individual
Prefix:DR
First Name:SAVITHRI-CHANDANA
Middle Name:
Last Name:VELURI
Suffix:
Gender:F
Credentials:VA
Other - Prefix:DR
Other - First Name:CHANDANA
Other - Middle Name:
Other - Last Name:VELURI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3700 FETTLER PARK
Mailing Address - Street 2:DUMFRIES HEALTH CENTER
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025
Mailing Address - Country:US
Mailing Address - Phone:703-441-7500
Mailing Address - Fax:
Practice Address - Street 1:3700 FETTLER PARK
Practice Address - Street 2:DUMFRIES HEALTH CENTER
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025
Practice Address - Country:US
Practice Address - Phone:703-441-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78107207Q00000X
PAMD429390207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA112325OtherBOARD CERT #
PAMD429390OtherPA LICENSE
CA00A781070OtherBLUE SHIELD OF CA PIN
CABV7757238OtherDEA CERT
CA112325OtherBOARD CERT #
PAMD429390OtherPA LICENSE