Individual
AMUDHA PALANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12655 WARWICK BLVD, SUITE A, NEWPORT NEWS, VA 23606-2501
(757) 595-9880
(757) 595-0362
Mailing address
860 OMNI BLVD, SUITE #303, NEWPORT NEWS, VA 23602
(757) 232-8777
(757) 232-8866
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101240408
VA
207Q00000X
Family Medicine Physician
Primary
0101240408
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952428682
—
VA
01
—
302221
ANTHEM
VA
Enumeration date
03/26/2007
Last updated
08/15/2013
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