Provider Demographics
NPI:1265406607
Name:YELLINEDI, SUJATHA (MD)
Entity type:Individual
Prefix:DR
First Name:SUJATHA
Middle Name:
Last Name:YELLINEDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7202 GLEN FOREST DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3781
Mailing Address - Country:US
Mailing Address - Phone:804-673-2024
Mailing Address - Fax:804-673-1796
Practice Address - Street 1:200 MEDICAL PARK BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9274
Practice Address - Country:US
Practice Address - Phone:804-431-1100
Practice Address - Fax:804-862-1094
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101237658207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541989200OtherTRICARE
VA541989200OtherMAILHANDLERS
VA541989200OtherUNITED HEALTH CARE
VA541989200OtherCIGNA
VA010148707Medicaid
VA177532OtherBCBS
VA010148723Medicaid
VAVVL973AMedicare PIN
VA541989200OtherMAILHANDLERS