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Individual

DR. KAPPA M PEDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1330 OAK LN, SUITE 101, LYNCHBURG, VA 24503
(434) 847-6132
(434) 845-4870
Mailing address
1330 OAK LN, SUITE 101, LYNCHBURG, VA 24503-2513
(434) 847-6132
(434) 845-4870

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101225823
VA
207ND0900X
Dermatopathology Physician
0101225823
VA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
0101225823
VA
207NP0225X
Pediatric Dermatology Physician
0101225823
VA
207NS0135X
Procedural Dermatology Physician
0101225823
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070015463
MEDICARE RAILROAD
VA
01
216440
ANTHEM
VA
01
310025
SOUTHERN HEALTH
VA
01
541667390
TAX ID
VA
05
5901839
VA
01
8152058
CIGNA
VA
Enumeration date
05/22/2006
Last updated
08/07/2018
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