Pendyala, Venkata Susrut
Pendyala, Venkata Susrut is an individual health care provider with primary practice located at 1100 Goethals Dr Ste F , Richland WA 99352-3301. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Pendyala, Venkata Susrut can be contacted via phone (509) 942-3272.Contact Information
Primary practice address
1100 Goethals Dr Ste F
Richland WA 99352-3301
Phone: (509) 942-3272
Fax: (509) 942-3273
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-138524 | Illinois |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD61171799 | Washington |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MD61171799 | Washington |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | MD61171799 | Washington |
Profile Details
| NPI number | 1831444553 |
|---|---|
| LBN Legal business name | Pendyala, Venkata Susrut |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2012 |
| Last updated | Sep 20th, 2021 - about 4 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 | 1831444553 | NPPES |
| Illinois | MEDICAID | 036138524 |
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