Organization
SOUTHSIDE PHYSICIANS FOR WOMEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISHNA RAO KUDARAVALLI M.D. (OWNER)
(804) 862-3455
Entity
Organization
Contact information
Practice address
510 S SYCAMORE ST, SUITE A & B, PETERSBURG, VA 23803-5044
(804) 862-3455
(804) 862-1439
Mailing address
510 S SYCAMORE ST, SUITE A & B, PETERSBURG, VA 23803-5044
(804) 862-3455
(804) 862-1439
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
06/25/2007
Last updated
11/13/2007
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