Healthcare Provider Details

I. General information

NPI: 1972604643
Provider Name (Legal Business Name): KNV SANKARAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 W WASHINGTON ST
SUFFOLK VA
23434
US

IV. Provider business mailing address

PO BOX 1815 440 W WASHINGTON ST
SUFFOLK VA
23439-1815
US

V. Phone/Fax

Practice location:
  • Phone: 757-539-4822
  • Fax: 757-925-0346
Mailing address:
  • Phone: 757-539-4822
  • Fax: 757-925-0346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KALATHIL NV SANKARAN
Title or Position: PRESIDENT
Credential: MD
Phone: 757-539-4822