Provider Demographics
NPI:1457793069
Name:SARKARIA, GURDAMAN KAUR (OD)
Entity type:Individual
Prefix:DR
First Name:GURDAMAN
Middle Name:KAUR
Last Name:SARKARIA
Suffix:
Gender:F
Credentials:OD
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Other - Credentials:
Mailing Address - Street 1:1712 E BROAD STREET
Mailing Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL SHOCKOE BOTTOM, LLC
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223
Mailing Address - Country:US
Mailing Address - Phone:804-344-9848
Mailing Address - Fax:804-344-5644
Practice Address - Street 1:1712 E BROAD STREET
Practice Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL SHOCKOE BOTTOM, LLC
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223
Practice Address - Country:US
Practice Address - Phone:804-344-9848
Practice Address - Fax:804-344-5644
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0618002280152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0618002280OtherSTATE MEDICAL LICENSE