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Organization

SOUTHSIDE KIDNEY SPECIALISTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. VIJAYA LAKSHMI CHIRUMAMILLA M.D. (PRESIDENT)
(804) 733-6960
Entity
Organization

Contact information

Practice address
3400 S CRATER RD, SUITE B, PETERSBURG, VA 23805-9211
(804) 733-6960
(804) 733-3880
Mailing address
3400 S CRATER RD, SUITE B, PETERSBURG, VA 23805-9211
(804) 733-6960
(804) 733-3880

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Enumeration date
07/22/2006
Last updated
08/22/2020
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