Provider Demographics
NPI:1831497064
Name:GUDA, VEERA REDDY
Entity Type:Individual
Prefix:MR
First Name:VEERA
Middle Name:REDDY
Last Name:GUDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 WESTGATE RD
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-6571
Mailing Address - Country:US
Mailing Address - Phone:804-732-0719
Mailing Address - Fax:804-733-7609
Practice Address - Street 1:4310 WESTGATE RD
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-6571
Practice Address - Country:US
Practice Address - Phone:804-732-0719
Practice Address - Fax:804-733-7609
Is Sole Proprietor?:No
Enumeration Date:2011-03-12
Last Update Date:2011-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist