Healthcare Provider Details

I. General information

NPI: 1043895576
Provider Name (Legal Business Name): VIHAAN SAI KRISHNA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2021
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 MAPLEWOOD AVE
RICHMOND VA
23220-5700
US

IV. Provider business mailing address

PO BOX 11768
RICHMOND VA
23230-0168
US

V. Phone/Fax

Practice location:
  • Phone: 804-387-1643
  • Fax: 804-213-9783
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KAVITHA KROTTAPALLI
Title or Position: PRESIDENT
Credential: MD
Phone: 804-387-1643