Koduri, Prashanthi Bora
Koduri, Prashanthi Bora is an individual health care provider with primary practice located at 3920 Bridge Rd Bldg A, Ste. 207, Suffolk VA 23435-1117. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Koduri, Prashanthi Bora can be contacted via phone (757) 983-2200.Contact Information
Primary practice address
3920 Bridge Rd Bldg A, Ste. 207
Suffolk VA 23435-1117
Phone: (757) 983-2200
Fax: (757) 923-2201
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 101229036 | Virginia |
Profile Details
| NPI number | 1891744603 |
|---|---|
| LBN Legal business name | Koduri, Prashanthi Bora |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 9th, 2006 |
| Last updated | Dec 6th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891744603 | NPPES |
| Virginia | MEDICAID | 10048061 |
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