Provider Demographics
NPI:1245422674
Name:SAKUNTLA PLLC
Entity type:Organization
Organization Name:SAKUNTLA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAKUNTLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KONDRAGUNTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-733-3333
Mailing Address - Street 1:700 S SYCAMORE ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-5803
Mailing Address - Country:US
Mailing Address - Phone:804-733-3333
Mailing Address - Fax:804-863-0795
Practice Address - Street 1:700 S SYCAMORE ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-5803
Practice Address - Country:US
Practice Address - Phone:804-733-3333
Practice Address - Fax:804-863-0795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center