Provider Demographics
NPI:1487692968
Name:PANDURANGI, ANANDA K (MD)
Entity type:Individual
Prefix:DR
First Name:ANANDA
Middle Name:K
Last Name:PANDURANGI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1300 E MARSHALL ST
Mailing Address - Street 2:NORTH HOSPITAL ROOM 8053
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-5054
Mailing Address - Country:US
Mailing Address - Phone:804-828-4570
Mailing Address - Fax:804-828-4614
Practice Address - Street 1:1300 E MARSHALL ST
Practice Address - Street 2:NORTH HOSPITAL ROOM 8053
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5054
Practice Address - Country:US
Practice Address - Phone:804-828-4570
Practice Address - Fax:804-828-4614
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA367822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7104049Medicaid
B62196Medicare UPIN