Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 0101251547 | VA |
NPI | 1023044765 |
---|---|
Provider Name | Dr. Umadevi Muthyala |
First Address | Colonial Heights, VA 23834-1345 |
Second Address | Colonial Heights, VA 23834-1345 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 05/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C09633 | GROUP PTAN (01) | VA |