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Organization

VIRGINIA NEPHROLOGY GROUP, LLP

Active
Other names
Drs Bazaz and Cheriyan, Partnership
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RENUKA SOTHINATHAN M.D. (MANAGING PARTNER)
(703) 246-9246
Entity
Organization

Contact information

Practice address
3930 WALNUT STREET, SUITE 101, FAIRFAX, VA 22030-4738
(703) 246-9246
(703) 246-9257
Mailing address
3930 WALNUT STREET, SUITE 101, FAIRFAX, VA 22030-4738
(703) 246-9246
(703) 246-9257

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4743
CAREFIRST
Enumeration date
10/03/2006
Last updated
08/09/2023
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