Organization
SRIKANTH MAHAVADI, DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRIKANTH MAHAVADI DPM (PRESIDENT)
(804) 966-8350
Entity
Organization
Contact information
Practice address
9050 POCAHONTAS TRAIL, SUITE #F, PROVIDENCE FORGE, VA 23140-0357
(804) 966-8350
(804) 966-8999
Mailing address
PO BOX 357, PROVIDENCE FORGE, VA 23140-0357
(804) 966-8350
(805) 966-8999
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009301429
—
VA
Enumeration date
06/17/2010
Last updated
06/17/2010
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