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Individual

ANUP KRISHNA GANGAVALLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5899 BREMO ROAD, SUITE 100, RICHMOND, VA 23226
(804) 288-8512
Mailing address
P. O. BOX 715868, PHILADELPHIA, PA 19171-4067
(804) 215-3063

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101272652
VA
207X00000X
Orthopaedic Surgery Physician
ME136492
FL
207X00000X
Orthopaedic Surgery Physician
MT202570
PA

Other

Enumeration date
07/02/2012
Last updated
10/06/2022
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