Provider Demographics
NPI:1619089497
Name:KATARI, SREELATHA (MD,)
Entity Type:Individual
Prefix:DR
First Name:SREELATHA
Middle Name:
Last Name:KATARI
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 1:333 W CORK ST
Mailing Address - Street 2:SUITE 145
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3870
Mailing Address - Country:US
Mailing Address - Phone:540-536-5121
Mailing Address - Fax:540-536-5129
Practice Address - Street 1:333 W CORK ST
Practice Address - Street 2:SUITE 145
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3870
Practice Address - Country:US
Practice Address - Phone:540-536-5121
Practice Address - Fax:540-536-5129
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012221852081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810007482Medicaid
WV3810007482Medicaid
VA011255W68Medicare ID - Type Unspecified