Provider Demographics
NPI:1760505168
Name:GOGINENI, APARNA (MD)
Entity Type:Individual
Prefix:DR
First Name:APARNA
Middle Name:
Last Name:GOGINENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:APARNA
Other - Middle Name:
Other - Last Name:GOGINENI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 CLINIC DR
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-1102
Mailing Address - Country:US
Mailing Address - Phone:276-964-1281
Mailing Address - Fax:276-964-1238
Practice Address - Street 1:1 CLINIC DR
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-1102
Practice Address - Country:US
Practice Address - Phone:276-964-1281
Practice Address - Fax:276-964-1238
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101247726207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1760505168Medicaid