Organization
KADARNATH S BOODRAM MD LLC
Active
Other names
K.S. Boodram, MD PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON BOODRAM (PRACTICE MANAGER)
(804) 526-7900
Entity
Organization
Contact information
Practice address
4300 CROSSINGS BLVD STE 101, PRINCE GEORGE, VA 23875-1452
(804) 526-7900
(804) 526-7195
Mailing address
4300 CROSSINGS BLVD STE 101, PRINCE GEORGE, VA 23875-1452
(804) 526-7900
(804) 526-7195
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101229800
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010124701
—
VA
01
—
0408689
UNITED HEALTHCARE
VA
01
—
0504963
CIGNA
VI
01
—
172714
ANTHEM
VA
01
—
254668
SOUOTHERN HEALTH
VI
01
—
3689195
AETNA HMO
VA
01
—
54180
CARENET
VI
01
—
7404178
AETNA PPO
VA
01
—
7604973
GHI
VA
01
—
8130003
MAMSI
VI
01
—
94167
SENTARA OPTIMA
VA
Enumeration date
05/25/2007
Last updated
03/10/2024
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