Healthcare Provider Details

I. General information

NPI: 1720008261
Provider Name (Legal Business Name): KRISHNA BRAHMA SASTRY TOPALLI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TOPALLI KB SASTRY MD

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 BATTLEFIELD BLVD N SUITE B
CHESAPEAKE VA
23320-0306
US

IV. Provider business mailing address

676 BATTLEFIELD BLVD N SUITE B
CHESAPEAKE VA
23320-0306
US

V. Phone/Fax

Practice location:
  • Phone: 757-410-4219
  • Fax: 757-410-4237
Mailing address:
  • Phone: 757-410-4219
  • Fax: 757-410-4237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number0101236432
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: