| Reliant MD Group LLC | |
|
19450 Deerfield Ave Ste 325 Leesburg VA 20176-8503 | |
| (703) 994-6655 | |
| (571) 291-2752 |
| Full Name | Reliant MD Group LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 19450 Deerfield Ave Ste 325, Leesburg, Virginia |
| Authorized Official Name and Position | Suman Manchireddy (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Contact | 7039946655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reliant MD Group LLC Attn. Lori Grimm 20349 Medalist Drive Ashburn VA 20147 Ph: (703) 994-6655 | Reliant MD Group LLC 19450 Deerfield Ave Ste 325 Leesburg VA 20176-8503 Ph: (703) 994-6655 |
| NPI Number | 1154810901 |
|---|---|
| Provider Enumeration Date | 05/08/2018 |
| Last Update Date | 05/08/2018 |
| Medicare PECOS PAC ID | 1254682917 |
|---|---|
| Medicare Enrollment ID | O20180919004204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154810901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101254080 (Virginia) | Primary |
| Provider Name | Suman Manchireddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164676037 PECOS PAC ID: 8921158569 Enrollment ID: I20130919000161 |
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