MEDICARE: DR. BUTCHAIAH KONDRAGUNTA M.D.

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	337600	OTHER	VA	BCBS
3	541989200	OTHER	VA	MAILHANDLERS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1316020399	OTHER	VA	HEMATOLOGY/ONCOLOGY
6	258076	OTHER	VA	BCBS
7	7608086	OTHER	VA	AETNA
8	26641	OTHER	VA	CIGNA

General Provider Information

NPI Number	:	1871567214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BUTCHAIAH KONDRAGUNTA M.D.

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 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

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	05/22/2012

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

1316020399 — S.B.KONDRAGUNTA LLC
Practice Location Address:

34-G MEDICAL PARK BLVD., , 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 “ DR. BUTCHAIAH KONDRAGUNTA M.D.” 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.