Provider Demographics
NPI:1518692086
Name:VOGIRALA, SIDDHARTHA SAI TEJA (DO)
Entity type:Individual
Prefix:
First Name:SIDDHARTHA
Middle Name:SAI TEJA
Last Name:VOGIRALA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:220 CAMPUS BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2889
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:759 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1154
Practice Address - Country:US
Practice Address - Phone:540-459-1383
Practice Address - Fax:540-459-1382
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR3748207R00000X
VA0102209427207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty