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SOUTHSIDE PHYSICIANS FOR WOMEN LLC NPI 1811193055


NPI Information

NPI: 1811193055
Provider Name: SOUTHSIDE PHYSICIANS FOR WOMEN, LLC
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
510 S SYCAMORE ST
SUITE A & B
PETERSBURG, VA
ZIP 23803
Phone: (804) 862-3455
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SOUTHSIDE PHYSICIANS FOR WOMEN, LLC is an obstetrics gynecology in Petersburg, VA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. SOUTHSIDE PHYSICIANS FOR WOMEN, LLC NPI is 1811193055. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

510 S SYCAMORE ST
SUITE A & B
PETERSBURG, VA
ZIP 23803-044
Phone: (804) 862-3455
Fax: (804) 862-1439

The provider's authorized official is Krishna Rao Kudaravalli .
The authorized official title is Owner and has the following contact phone number (804) 862-3455.

The enumeration date for this NPI number is 6/25/2007 and was last updated on 11/13/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & GynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C08164MEDICARE PINVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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