Provider Demographics
NPI:1902283013
Name:LAKKAKULA, VAMSEE MOHANA (MD)
Entity type:Individual
Prefix:DR
First Name:VAMSEE
Middle Name:MOHANA
Last Name:LAKKAKULA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:111 MEDICAL PKWY FL 2
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-0302
Mailing Address - Country:US
Mailing Address - Phone:757-312-4047
Mailing Address - Fax:757-410-0339
Practice Address - Street 1:111 MEDICAL PKWY FL 2
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-0302
Practice Address - Country:US
Practice Address - Phone:757-312-4047
Practice Address - Fax:757-410-0339
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2024-10-03
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Provider Licenses
StateLicense IDTaxonomies
NY310853207RC0000X
NC2023-02240207RC0000X
VA0101283205207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease