Provider Demographics
NPI:1730373846
Name:SRIRAMA, ROHITH (MD)
Entity type:Individual
Prefix:DR
First Name:ROHITH
Middle Name:
Last Name:SRIRAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 BORDEAUX PL
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23509-1334
Mailing Address - Country:US
Mailing Address - Phone:919-619-3798
Mailing Address - Fax:
Practice Address - Street 1:1510 BORDEAUX PL
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23509-1334
Practice Address - Country:US
Practice Address - Phone:919-619-3798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241821207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology