Individual
SUDHA KODURU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5991
Mailing address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5991
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01012500380
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/02/2008
Last updated
04/06/2015
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