Individual
SOWMYA SRIMANTHULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 AUBREYS LOOP, SOUTH BOSTON, VA 24592-5054
(434) 517-3879
Mailing address
101 AUBREYS LOOP, SOUTH BOSTON, VA 24592-5054
(434) 517-3879
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101274781
VA
390200000X
Student in an Organized Health Care Education/Training Program
33899
OK
Other
Enumeration date
07/04/2018
Last updated
01/12/2024
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