Healthcare Provider Details

I. General information

NPI: 1770353252
Provider Name (Legal Business Name): SUMINTRA PARKER MED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2024
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7760 SHRADER RD STE B
HENRICO VA
23228-2552
US

IV. Provider business mailing address

101 MANCHESTER RD APT 326
RICHMOND VA
23224-4374
US

V. Phone/Fax

Practice location:
  • Phone: 804-591-0002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: