Raju, Venkedesh
Raju, Venkedesh is an sole proprietor health care provider with primary practice located at 1001 Pennsylvania Ave , Ottumwa IA 52501-6427. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Raju, Venkedesh can be contacted via phone (641) 682-7511.Contact Information
Primary practice address
1001 Pennsylvania Ave
Ottumwa IA 52501-6427
Phone: (641) 682-7511
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 125050775 | Illinois |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD-42748 | Iowa |
Profile Details
| NPI number | 1053512814 |
|---|---|
| LBN Legal business name | Raju, Venkedesh |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 30th, 2007 |
| Last updated | Feb 18th, 2020 - about 5 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 | 1053512814 | NPPES |
| Illinois | Other | 809840 | MEDICARE GROUP PTAN |
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