Provider Demographics
NPI:1306951116
Name:SUBRAMANIAM, SARITA GOLIKERI (MD)
Entity type:Individual
Prefix:
First Name:SARITA
Middle Name:GOLIKERI
Last Name:SUBRAMANIAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARITA
Other - Middle Name:GANESH
Other - Last Name:GOLIKERI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:860 OMNI BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8769
Mailing Address - Fax:757-232-8875
Practice Address - Street 1:4125 IRONBOUND RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2666
Practice Address - Country:US
Practice Address - Phone:757-345-2829
Practice Address - Fax:757-345-0644
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246836207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine