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Individual

DR. RENUKA S. MOOTHATHU

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5855 BREMO RD, SUITE 210, RICHMOND, VA 23226-1926
(804) 282-0655
(804) 282-0717
Mailing address
5855 BREMO RD, SUITE 210, RICHMOND, VA 23226-1926
(804) 282-0655
(804) 282-0717

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101053102
VA

Other

Enumeration date
09/30/2005
Last updated
07/08/2007
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