Individual
DR. MARUTHI V GOTTIMUKKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
844 KEMPSVILLE RD STE 204, NORFOLK, VA 23502-3927
(757) 261-0700
Mailing address
844 KEMPSVILLE RD STE 204, NORFOLK, VA 23502-3927
(757) 261-0700
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101041083
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-001
TRICARE CHAMPUS
VA
05
—
010226805
—
VA
01
—
0604X
NC BC/BS
NC
01
—
10015737
SENTARA OPTIMA
VA
01
—
15848
OPTIMA HEALTH PLAN
VA
05
—
1861428518
—
VA
01
—
187095
ANTHEM BC/BS
VA
01
—
295590
ANTHEM
VA
01
—
313773
MAMSI
VA
01
—
413773
UHC/MAMSI
VA
05
—
890604X
—
NC
01
—
PAR
VIRGINIA PREMIER HEALTH
VA
Enumeration date
06/24/2006
Last updated
07/24/2024
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