Individual
DR. SRIDHAR MADHUNAPANTULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 722-9961
Mailing address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 722-9961
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101238020
VA
207R00000X
Internal Medicine Physician
ME95109
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101241090
—
VA
01
—
381000448
WV MEDICAID NUMBER
VA
Enumeration date
07/30/2006
Last updated
08/18/2023
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