Raju, Dinesh Venkoba

Raju, Dinesh Venkoba is an individual health care provider with primary practice located at 475 Philip Blvd Ste 200 , Lawrenceville GA 30046-8737. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Raju, Dinesh Venkoba can be contacted via phone (678) 226-6201.

Contact Information

Primary practice address
475 Philip Blvd Ste 200 Lawrenceville GA 30046-8737
Fax: (678) 225-4037
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sleep Medicine 2084S0012X 065880 Georgia
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 065880 Georgia

Profile Details

NPI number 1548465198
LBN Legal business name Raju, Dinesh Venkoba
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2007
Last updated Jan 14th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548465198 NPPES
Georgia MEDICAID 003119067

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