Organization
SRI SAI RAJ,LLC
Active
Organization
SRI SAI RAJ,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PADMALATHA DHARANIKOTA MD (PRESIDENT)
(687) 492-9804
Entity
Organization
Contact information
Practice address
7600 AUTUMN PARK WAY, MECHANICSVILLE, VA 23116-3868
(804) 730-0009
Mailing address
PO BOX 31494, HENRICO, VA 23294-1494
(804) 282-9133
(804) 282-9135
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101237077
VIRGINIA MEDICAL LICENSE
VA
Enumeration date
04/30/2020
Last updated
04/30/2020
Update your record
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