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General NPI Number Information
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NPI Number | 1831414739
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Entity Type | Individual
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Provider Name | RAMAN UNNIKRISHNAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2010
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 7185 HARBOUR TOWNE PKWY S STE 200
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City | SUFFOLK
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State | VA
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Zip | 23435-3796
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Country | US
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Telephone | 757-457-5100
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Fax | 757-961-3934
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Provider Business Mailing Address
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Address Line | 225 CLEARFIELD AVE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1815
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Country | US
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Telephone | 757-457-5100
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Fax | 757-961-3934
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0101260018
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License Number State | VA
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