Individual
VIDYA NAGAMANGALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS, MPH
Contact information
Practice address
5801 BREMO RD, RICHMOND, VA 23226-1907
(804) 285-0620
Mailing address
5801 BREMO RD, RICHMOND, VA 23226-1907
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101247158
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116019062
VA
Other
Enumeration date
07/07/2008
Last updated
10/08/2014
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