JEEVAN ERRABOLU

Address: 503 Byrn St Ste 1, Ste 1, Cambridge, MD 21613-1917
Phone: 4102217770

JEEVAN ERRABOLU (NPI# 1215165543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215165543
Entity Type 1 - Individual
Full Name JEEVAN ERRABOLU
Credential M.D.
Practice Address 503 Byrn St Ste 1
Ste 1
Cambridge
MD 21613-1917
Mailing Address 105 Aurora St
Cambridge
MD 21613-1903
Practice Telephone 4102217770
Practice Fax Number 4102217863
Mailing Telephone 4102289515
Mailing Fax Number 4102283009
Enumeration Date 06/25/2009
Last Update Date 01/19/2012
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine D69234 MD Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MD 418278200 05

Office Location

Street Address 503 BYRN ST STE 1
STE 1
City CAMBRIDGE
State MD
Zip Code 21613-1917

Providers with the same location

NPI Name Address
1659360469 NOMAN THANWY 503 Byrn St Ste 1, Cambridge, MD 21613-1917

Competitor

Search similar physicians

City CAMBRIDGE
Zip Code 21613

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.