Provider Demographics
NPI:1316741739
Name:KANAKANNAVAR, SANCHITA SURESH (MD)
Entity type:Individual
Prefix:DR
First Name:SANCHITA
Middle Name:SURESH
Last Name:KANAKANNAVAR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 15TH ST. NW NORTON IM RESIDENCY CLINIC
Mailing Address - Street 2:SUITE 111
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273
Mailing Address - Country:US
Mailing Address - Phone:276-439-1872
Mailing Address - Fax:276-439-1872
Practice Address - Street 1:96 15TH ST. NW NORTON IM RESIDENCY CLINIC
Practice Address - Street 2:SUITE 111
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273
Practice Address - Country:US
Practice Address - Phone:276-439-1872
Practice Address - Fax:276-439-1872
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program