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Organization

FARMVILLE INTERNAL MEDICINE, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VARA P BONAGIRI M.D. (PRESIDENT)
(434) 392-9000
Entity
Organization

Contact information

Practice address
1400 MILNWOOD RD, FARMVILLE, VA 23901-2633
(434) 392-9000
(434) 392-9215
Mailing address
PO BOX R, FARMVILLE, VA 23901-0289
(434) 392-9000
(434) 392-9215

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101054184
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5865514
VA
Enumeration date
01/18/2011
Last updated
03/02/2012
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