Individual
SHRUTHI SAMBAMOORTHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1712 E BROAD ST, RICHMOND, VA 23223-6930
(804) 344-9848
Mailing address
1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
(804) 344-9848
(804) 344-5644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101262213
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2014
Last updated
03/25/2020
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