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Individual

ANURADHA GONUGUNTLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5360 TWIN HICKORY RD, GLEN ALLEN, VA 23059-5682
(804) 346-3200
(804) 346-4075
Mailing address
1800 GLENSIDE DR, STE 105, RICHMOND, VA 23226-3769
(804) 288-2762
(804) 285-0088

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7823
SD
207Q00000X
Family Medicine Physician
RL10545
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12083
ND
Enumeration date
10/29/2007
Last updated
06/01/2016
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