Provider Demographics
NPI:1467483875
Name:VUYYURU, SUJATHA P (MD)
Entity Type:Individual
Prefix:DR
First Name:SUJATHA
Middle Name:P
Last Name:VUYYURU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 OLD BERMUDA HUNDRED RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-5609
Mailing Address - Country:US
Mailing Address - Phone:804-530-9966
Mailing Address - Fax:804-530-2667
Practice Address - Street 1:110 OLD BERMUDA HUNDRED RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-5609
Practice Address - Country:US
Practice Address - Phone:804-530-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051582207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08736Medicare PIN
VAG18503Medicare UPIN