Healthcare Provider Details

I. General information

NPI: 1194459941
Provider Name (Legal Business Name): SANJANA RAMAKRISHNAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 W BRAMBLETON AVE
NORFOLK VA
23510-1005
US

IV. Provider business mailing address

855 W BRAMBLETON AVE
NORFOLK VA
23510-1005
US

V. Phone/Fax

Practice location:
  • Phone: 602-386-7227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number0116041171
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: