Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0101027177 | VA |
NPI | 1003919622 |
---|---|
Provider Name | Dr. Nellie M Sankaran |
First Address | Suffolk, VA 23439-1815 |
Second Address | Suffolk, VA 23439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B07737 | (02) |