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Individual

LISA J THANNIKARY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1215 LEE ST, DEPARTMENT OF ANESTHESIOLOGY, CHARLOTTESVILLE, VA 22908-0710
(434) 924-9508
Mailing address
1624 GATEWICK PL, KESWICK, VA 22947-9119
(434) 202-2980

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101248535
VA
207L00000X
Anesthesiology Physician
ME87621
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
267044500
FL
Enumeration date
06/03/2008
Last updated
11/15/2010
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