Individual ProviderBobby SeInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address3300 Gallows Rd, Falls Church, VA 22042-3307(703) 776-3582(019) 845-6156PECOS EnrollmentBased on the most recent information from CMS, provider Bobby Se 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 34 days ago.Profile DetailsProvider ID1114657152Provider TypeIndividualFull NameSe, BobbyCredentialMDGenderMaleSole ProprietorNoEnumeration Date6/13/2022Last Updated8/24/2025Contact InformationPractice LocationPractice Address3300 Gallows Rd, Falls Church, VA 22042-3307Phone(703) 776-3582FaxUnlisted FaxMailing LocationMailing Address2500 N State St, Jackson, MS 39216-4500Phone(019) 845-6156FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense35104MississippiCode207RH0003XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense35104MississippiCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense0116036429Virginia