Odeti, Shyam Sundhar
Odeti, Shyam Sundhar is an individual health care provider with primary practice located at 16000 Johnston Memorial Dr Fourth Floor, Abingdon VA 24211-7659. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Odeti, Shyam Sundhar can be contacted via phone (276) 258-4050.Contact Information
Primary practice address
16000 Johnston Memorial Dr Fourth Floor
Abingdon VA 24211-7659
Phone: (276) 258-4050
Fax: (276) 258-4056
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0101256639 | Virginia |
Profile Details
| NPI number | 1154614816 |
|---|---|
| LBN Legal business name | Odeti, Shyam Sundhar |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2011 |
| Last updated | Sep 18th, 2015 - about 10 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 | 1154614816 | NPPES |
| Virginia | MEDICAID | 1154614816 | |
| Virginia | Other | P01493724 |
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