Individual
NAGESH GOLLAHALLI SHIVARAMAIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
(757) 594-3580
(757) 594-3653
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.058686
IL
207R00000X
Internal Medicine Physician
294448
MA
208M00000X
Hospitalist Physician
Primary
0101260450
VA
Other
Enumeration date
07/26/2010
Last updated
12/15/2022
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