Individual
SRI LOGANATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
411 W RANDOLPH RD, HOPEWELL, VA 23860-2938
(804) 452-3624
Mailing address
PO BOX 17572, BALTIMORE, MD 21297-1572
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101027071
VA
207P00000X
Emergency Medicine Physician
8129
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010002401
—
VA
05
—
010055890
—
VA
05
—
1568487981
—
VA
Enumeration date
07/13/2006
Last updated
06/16/2011
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