Provider Demographics
NPI:1497384697
Name:BABU, SRIYA (DPM)
Entity type:Individual
Prefix:
First Name:SRIYA
Middle Name:
Last Name:BABU
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21475 RIDGETOP CIR STE 150
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6580
Mailing Address - Country:US
Mailing Address - Phone:703-444-5000
Mailing Address - Fax:703-444-4999
Practice Address - Street 1:21475 RIDGETOP CIR STE 150
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6580
Practice Address - Country:US
Practice Address - Phone:034-445-0007
Practice Address - Fax:703-444-4999
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10506213E00000X
390200000X
VA0103301422213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program