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
Phone: (678) 226-6201
Fax: (678) 225-4037
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548465198 | NPPES |
| Georgia | MEDICAID | 003119067 |
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