Provider Demographics
NPI:1972670446
Name:SOBHA R PALUVOI MD PC
Entity Type:Organization
Organization Name:SOBHA R PALUVOI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SOBHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PALUVOI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-729-8830
Mailing Address - Street 1:19415 DEERFIELD AVE
Mailing Address - Street 2:SUITE #210
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8452
Mailing Address - Country:US
Mailing Address - Phone:703-729-8830
Mailing Address - Fax:703-729-8477
Practice Address - Street 1:19415 DEERFIELD AVE
Practice Address - Street 2:SUITE #210
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8452
Practice Address - Country:US
Practice Address - Phone:703-729-8830
Practice Address - Fax:703-729-8477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012355322084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010090245Medicaid
VAC09056Medicare PIN