Individual
SRINIVASA C BOKKISAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7101 JAHNKE RD, SUITE 611, RICHMOND, VA 23225-4017
(804) 327-4046
(804) 327-4047
Mailing address
7101 JAHNKE RD, SUITE 611, RICHMOND, VA 23225-4017
(804) 327-4046
(804) 327-4047
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101239848
VA
208600000X
Surgery Physician
0101239848
VA
208M00000X
Hospitalist Physician
Primary
0101239848
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010318891
—
VA
01
—
P00380695
RAILROAD MEDICARE
VA
Enumeration date
08/05/2006
Last updated
12/27/2022
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