BANU PRASAD MYNENI

PORTSMOUTH, VA
NPI1780082693
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: VA  0102206019)
Additional Taxonomies207Q00000X Family Medicine
(Licence: IL  036-144866)
Enumeration Date2014-12-09
Last Update Date2024-05-14
Business Address
Dr. BANU PRASAD MYNENI D.O.
3235 ACADEMY AVE STE 101
PORTSMOUTH, VA 23703-3200
Phone number: 757-484-7386
Mailing Address
Dr. BANU PRASAD MYNENI D.O.
3235 ACADEMY AVE STE 101
PORTSMOUTH, VA 23703-3200
Phone number: 757-484-7386