| Organization Name: | SRIKANTH MAHAVADI, DPM PC |
| NPI Number: | 1750602389 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SRIKANTH MAHAVADI (PRESIDENT) |
| Mailing Address: | 9050 Pocahontas Trail Suite #f Providence Forge |
| State: | VA US |
| Postal Code: | 231400357 |
| Phone Number: | 8049668350 |
| Fax Number: | 8049668999 |
| NPI Enumeration Date: | 06/17/2010 |
| NPI Last Update Date: | 06/17/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP1100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Podiatric |
| Taxonomy Definition: | |