Individual
DR. SRIKANTH MAHAVADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
9050 POCAHONTAS TRL, STE#F, PROVIDENCE FORGE, VA 23140-3400
(804) 966-8350
(804) 966-8999
Mailing address
PO BOX 357, PROVIDENCE FORGE, VA 23140-0357
(804) 966-8350
(804) 966-8999
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
0103001025
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009301429
—
VA
Enumeration date
04/20/2006
Last updated
07/08/2007
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