Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 0101246836 | VA |
NPI | 1306951116 |
---|---|
Provider Name | Sarita Golikeri Subramaniam |
First Address | Newport News, VA 23606-4430 |
Second Address | Williamsburg, VA 23188-2666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 12/07/2019 |