Koduru, Banerje

Koduru, Banerje is an individual health care provider with primary practice located at 207 N 4Th Ave , Hopewell VA 23860-2503. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Koduru, Banerje can be contacted via phone (804) 541-0918.

Contact Information

Primary practice address
207 N 4Th Ave Hopewell VA 23860-2503
Phone: (804) 541-0918
Fax: (804) 541-7924
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01010300086 Virginia

Profile Details

NPI number 1285644104
LBN Legal business name Koduru, Banerje
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Sep 10th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285644104 NPPES
Virginia MEDICAID 007140436

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