Organization
SOUTHSIDE KIDNEY SPECIALISTS
Active
Parent organization
SOUTHSIDE KIDNEY SPECIALISTS
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHSIDE KIDNEY SPECIALISTS
Authorized official
VIJAYA LAKSHMI CHIRUMAMILLA MD (OWNER)
(804) 733-6960
Entity
Organization
Contact information
Practice address
3400 S CRATER RD, STE #B, PETERSBURG, VA 23805-9252
(804) 733-6960
(804) 733-3880
Mailing address
201 E. FERRELL ST, SOUTH HILL, VA 23970-2202
(434) 447-3455
(434) 447-3405
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
05/07/2013
Last updated
05/07/2013
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