Individual
DR. SAKUNTLA KONDRAGUNTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5991
(804) 765-5809
Mailing address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5991
(804) 765-5809
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101222345
VA
208M00000X
Hospitalist Physician
Primary
0101222345
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010107318
—
VA
01
—
1184695843
ANTHEM BCBS
VA
05
—
1184695843
—
VA
Enumeration date
01/31/2006
Last updated
07/31/2009
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