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General NPI Number Information
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NPI Number | 1306054325
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Entity Type | Individual
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Provider Name | SUDHIR NAGARAJA DO
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/07/2013
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Provider Practice Location Address
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Address Line | 1312 PROVIDENCE RIDGE TURN
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City | RICHMOND
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State | VA
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Zip | 23236-2187
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Country | US
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Telephone | 804-658-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 PRINCESS ANNE ST SUITE 100
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3254
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Country | US
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Telephone | 540-479-1319
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Fax | 540-479-1326
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0102202111
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License Number State | VA
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