Provider Demographics
NPI:1689343295
Name:SRIPERUMBUDURI, SRIRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SRIRAM
Middle Name:
Last Name:SRIPERUMBUDURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 780125
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0125
Mailing Address - Country:US
Mailing Address - Phone:804-922-4844
Mailing Address - Fax:804-327-3065
Practice Address - Street 1:1001 E LEIGH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5004
Practice Address - Country:US
Practice Address - Phone:804-828-9682
Practice Address - Fax:804-828-7567
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2023-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101279231207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology