Krishna Rao Kudaravalli (NPI# 1104810142, PAC ID# 9032386313) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1104810142 |
| PAC ID by PECOS | 9032386313 |
| Professional Enrollment ID | I20120127000458 |
| Full Name | Krishna Rao Kudaravalli |
| Organization Legal Name | SOUTHSIDE PHYSICIAN NETWORK LLC |
| Address |
3335 S Crater Rd Petersburg VA 23805-9214 |
| Gender | M |
| Graduation Year | 1974 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 4587722160 |
| Number of Group Practice Members | 62 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490067 | SOUTHSIDE REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 8047655000 | SOUTHSIDE PHYSICIAN NETWORK LLC |
| 3335 S Crater Rd, Petersburg, VA 23805-9214 | SOUTHSIDE PHYSICIAN NETWORK LLC | |
| 40 Medical Park Blvd A, Petersburg, VA 23805-9289 | 8045047900 | SOUTHSIDE PHYSICIAN NETWORK LLC |
| 40 Medical Park Blvd B, Petersburg, VA 23805-9289 | 8045206730 | SOUTHSIDE PHYSICIAN NETWORK LLC |
| 40 Medical Park Blvd D, Petersburg, VA 23805-9289 | 8045202626 | SOUTHSIDE PHYSICIAN NETWORK LLC |
| 4221 Crossings Blvd, Prince George, VA 23875-1456 | 8047655206 | SOUTHSIDE PHYSICIAN NETWORK LLC |
| Organization Legal Name | SOUTHSIDE PHYSICIAN NETWORK LLC |
| Physicians | 55 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberley Lingler | Family Medicine | Southside Physician Network LLC | 12801 Iron Bridge Rd, Suite 200, Chester, VA 23831-1669 |
| Firas Kaddaha | Cardiovascular Disease (cardiology) | Southside Physician Network LLC | 727 N Main St, Emporia, VA 23847-1274 |
| Clifton Hawkes | Infectious Disease | Southside Physician Network LLC | 50 Medical Park Blvd, Petersburg, VA 23805-9275 |
| John Martin Yosay | Family Medicine | Southside Physician Network LLC | 436 Clairmont Ct, Suite 100, Colonial Heights, VA 23834-1765 |
| John W Lewis | Family Medicine | Southside Physician Network LLC | 40 Medical Park Blvd A, Petersburg, VA 23805-9289 |
| Spencer G Feldmann | Family Medicine | Southside Physician Network LLC | 511 Belfield Dr, Emporia, VA 23847-1217 |
| George Quarshie | Family Medicine | Southside Physician Network LLC | 20901 Chesterfield Ave, South Chesterfield, VA 23803-1903 |
| Harry A A Bigley | Urology | Southside Physician Network LLC | 436 Claremont Ct, Suite 104, Colonial Heights, VA 23834-1765 |
| Katri Ann French | Nurse Practitioner | Southside Physician Network LLC | 40 Medical Park Blvd A, Petersburg, VA 23805-9289 |
| Angela Allen-blaine | Nurse Practitioner | Southside Physician Network LLC | 40 Medical Park Blvd A, Petersburg, VA 23805-9289 |
| Street Address |
3335 S CRATER RD |
| City | PETERSBURG |
| State | VA |
| Zip | 23805-9214 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Paul J Meyers | Obstetrics/gynecology | Southside Physician Network LLC | 3335 S Crater Rd, Petersburg, VA 23805-9214 |
| Miguel Vega-gilormini | Obstetrics/gynecology | Southside Physician Network LLC | 3335 S Crater Rd, Petersburg, VA 23805-9214 |
| Justin Andrew Phillingane | Podiatry | Southside Physician Network LLC | 3335 S Crater Rd, Petersburg, VA 23805-9214 |
| Boyd R Wickizer Jr. | Emergency Medicine | 3335 S Crater Rd, Suite 700, Petersburg, VA 23805-9214 | |
| Anuoluwapo Akinsanya | Obstetrics/gynecology | Southside Physician Network LLC | 3335 S Crater Rd, Petersburg, VA 23805-9214 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nathan E Langer | Hematology/oncology | Virginia Cancer Institute Incorporated | 210 Medical Park Blvd, Suite 200, Petersburg, VA 23805-0002 |
| Sujatha Yellinedi | Medical Oncology | Virginia Cancer Institute Incorporated | 210 Medical Park Blvd, Suite 200, Petersburg, VA 23805-0002 |
| Nishanth Sukumaran | Hematology/oncology | Virginia Cancer Institute Incorporated | 210 Medical Park Blvd, Suite 200, Petersburg, VA 23805-0002 |
| Shobha R Nalluri | Hematology/oncology | Virginia Cancer Institute Incorporated | 210 Medical Park Blvd, Suite 200, Petersburg, VA 23805-0002 |
| Yogesh K Gandhi | Hematology | Virginia Cancer Institute Incorporated | 210 Medical Park Blvd, Suite 200, Petersburg, VA 23805-0002 |
| Tanikka Mason | Clinical Social Worker | 2002 Wakefield Ave, Petersburg, VA 23805-2112 | |
| Joseph W Siko Jr. | Podiatry | 2020 Wakefield Ave, Petersburg, VA 23805-2112 | |
| Samuel W Person | Podiatry | 2020 Wakefield St, Petersburg, VA 23805-2112 | |
| Nadeem Faruqi | Cardiovascular Disease (cardiology) | Dominion Cardiology PC | 2731 S Crater Rd, Petersburg, VA 23805-2403 |
| Edwan T Kibot | Nurse Practitioner | Dominion Cardiology PC | 2731 S Crater Rd, Petersburg, VA 23805-2403 |
| Find all physicians in zip 23805 | |||
| City | PETERSBURG |
| Zip Code | 23805 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | PETERSBURG + OBSTETRICS/GYNECOLOGY |
Please comment or provide details below to improve the information on Krishna Rao Kudaravalli.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.