Individual
DR. KRISHNA RAO KUDARAVALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
210 MEDICAL PARK BOULEVARD, SUITE 150, PETERSBURG, VA 23805-9274
(804) 765-5206
(804) 765-5809
Mailing address
436 CLAIRMONT CT STE 105, COLONIAL HEIGHTS, VA 23834-1765
(804) 765-5206
(804) 765-5809
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101033170
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006205411
—
VA
Enumeration date
09/06/2005
Last updated
01/19/2018
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