Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 0101247688 | VA |
NPI | 1568639466 |
---|---|
Provider Name | Dr. Santhosh Kumar Vasantha Kumar |
First Address | Richmond, VA 23291-1734 |
Second Address | Richmond, VA 23219-1930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2008 |
Last Update Date | 23/08/2020 |