Provider Demographics
NPI:1518083476
Name:RICHLANDS OB GYN ASSOCIATES PC
Entity Type:Organization
Organization Name:RICHLANDS OB GYN ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YELAMELI
Authorized Official - Middle Name:S
Authorized Official - Last Name:MURTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-964-6764
Mailing Address - Street 1:PO BOX 787
Mailing Address - Street 2:1100 CEDAR VALLEY DRIVE
Mailing Address - City:CEDAR BLUFF
Mailing Address - State:VA
Mailing Address - Zip Code:24609-0787
Mailing Address - Country:US
Mailing Address - Phone:276-964-6764
Mailing Address - Fax:276-964-6765
Practice Address - Street 1:1100 CEDAR VALLEY DR
Practice Address - Street 2:
Practice Address - City:CEDAR BLUFF
Practice Address - State:VA
Practice Address - Zip Code:24609-0787
Practice Address - Country:US
Practice Address - Phone:276-964-6764
Practice Address - Fax:276-964-6765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101023129207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA065556OtherANTHEM BLUE SHIELD
VA6241182Medicaid
VA065556OtherANTHEM BLUE SHIELD
B07688Medicare UPIN