Madhipatla, Venu M.
Madhipatla, Venu M. is an individual health care provider with primary practice located at 455 Philip Blvd Ste 140 , Lawrenceville GA 30046-8768. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Madhipatla, Venu M. can be contacted via phone (770) 962-3642.Contact Information
Primary practice address
455 Philip Blvd Ste 140
Lawrenceville GA 30046-8768
Phone: (770) 962-3642
Fax: (770) 962-3643
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 65559 | Georgia |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 065559 | Georgia |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 65559 | Georgia |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 65559 | Georgia |
Profile Details
| NPI number | 1578623278 |
|---|---|
| LBN Legal business name | Madhipatla, Venu M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 11th, 2006 |
| Last updated | Oct 1st, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578623278 | NPPES |
| Indiana | MEDICAID | 200973980 | |
| Indiana | MEDICAID | 003104831N | |
| Indiana | MEDICAID | 7100117730 | |
| Indiana | MEDICAID | 003104831A |
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