MEDICARE: S.B.KONDRAGUNTA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	0101223780	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1316020399	OTHER	VA	NPI
2	258076	OTHER	VA	BCBS
3	110214242	OTHER	VA	RAIL ROAD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	P00271749	OTHER	VA	RAIL ROAD

General Provider Information

NPI Number	:	1316020399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S.B.KONDRAGUNTA LLC

Provider Business Mailing Address
First Line	:	34 MEDICAL PARK BLVD STE G
Second Line	:	SUITE - G
City	:	PETERSBURG
State	:	VA
Zip	:	23805-9283
Country	:	US
Telephone Number	:	804-722-3100
Fax Number	:	804-722-3120

Provider Business Practice Location Address
First Line	:	34-G MEDICAL PARK BLVD.,
Second Line	:	SUITE - G
City	:	PETERSBURG
State	:	VA
Zip	:	23805-9283
Country	:	US
Telephone Number	:	804-722-3100
Fax Number	:	804-722-3120

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BUTCHAIAH KONDRAGUNTA
Credential	:	M.D
Telephone Number	:	804-722-3100

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	05/24/2012

Similar Medicare Providers

1083695209 — MARY ARRIETA MD
Practice Location Address:

34 MEDICAL PARK BLVD STE F
PETERSBURG, VA
23805-9283

Practice Phone: 804-520-8135
Practice Fax: 804-520-8092

1639159163 — DR. PAUL ERIC TSCHETSCHOT DC
Practice Location Address:

34 MEDICAL PARK BLVD , SUITE C
PETERSBURG, VA
23805-9283

Practice Phone: 804-862-2255
Practice Fax: 804-862-1004

1871567214 — DR. BUTCHAIAH KONDRAGUNTA M.D.
Practice Location Address:

34 MEDICAL PARK BLVD STE G , SUITE # G
PETERSBURG, VA
23805-9283

Practice Phone: 804-722-3100
Practice Fax: 804-722-3120

1588853824 — VALERIE L JASKOWSKI FNP
Practice Location Address:

34 MEDICAL PARK BLVD
PETERSBURG, VA
23805-9283

Practice Phone: 804-609-0175
Practice Fax:

1740439363 — MS. ALVA CARTER POPE LCSW
Practice Location Address:

34 MEDICAL PARK BLVD STE A
PETERSBURG, VA
23805-9283

Practice Phone: 804-609-0175
Practice Fax:

1669749529 — COMMONWEALTH ALLIANCE
Practice Location Address:

34 MEDICAL PARK BLVD STE C
PETERSBURG, VA
23805-9283

Practice Phone: 804-862-2255
Practice Fax: 804-862-1004

Directions to “S.B.KONDRAGUNTA LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.