Individual
DR. NISHA K SURENDERANATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
605 EMANCIPATION HWY, FREDERICKSBURG, VA 22401-8403
(540) 310-0117
(540) 310-4736
Mailing address
605 EMANCIPATION HWY STE 101, FREDERICKSBURG, VA 22401-8403
(423) 463-4713
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
0101272856
VA
2080P0202X
Pediatric Cardiology Physician
42283
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3000900
—
TN
Enumeration date
10/27/2006
Last updated
04/25/2022
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