Individual ProviderHarini GudavalliInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address3300 Gallows Rd, Falls Church, VA 22042-3307(703) 359-7460(301) 816-6660PECOS EnrollmentBased on the most recent information from CMS, provider Harini Gudavalli is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 10:37 AM.Profile DetailsProvider ID1306918891Provider TypeIndividualFull NameGudavalli, HariniTitleDr.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date11/14/2006Last Updated12/29/2021Contact InformationPractice LocationPractice Address3300 Gallows Rd, Falls Church, VA 22042-3307Phone(703) 359-7460Fax(703) 776-6593Mailing LocationMailing Address2101 East Jefferson Street, Ppqa Medicare Compliance Unit 6 West Attn Theresa Brook, Rockville, MD 20852-4908Phone(301) 816-6660Fax(301) 816-6308Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense0101055754Virginia