Provider Demographics
NPI:1841462959
Name:TRI CITY ARTHRITIS CENTER
Entity type:Organization
Organization Name:TRI CITY ARTHRITIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUJATHA
Authorized Official - Middle Name:P
Authorized Official - Last Name:VUYYURU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-530-9966
Mailing Address - Street 1:110 OLD BERMUDA HUNDRED RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-5609
Mailing Address - Country:US
Mailing Address - Phone:804-530-9966
Mailing Address - Fax:804-530-2667
Practice Address - Street 1:110 OLD BERMUDA HUNDRED RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-5609
Practice Address - Country:US
Practice Address - Phone:804-530-9966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051582207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG18503Medicare UPIN
VAC08736Medicare PIN