Healthcare Provider Details

I. General information

NPI: 1952559460
Provider Name (Legal Business Name): SRIVANI ANGADALA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E MARSHALL ST
RICHMOND VA
23298
US

IV. Provider business mailing address

BONSECOURS MEMORIAL MEDICAL CENTRE
RICHMOND VA
23249-0001
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9783
  • Fax:
Mailing address:
  • Phone: 804-764-7965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number0101248949
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: