Individual
LAKSHMIKANTAM VEMAVARAPU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-4990
(706) 721-8623
(706) 721-1459
Mailing address
1499 WALTON WAY STE 1400, AUGUSTA, GA 30901-2603
(706) 724-6100
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
01074475A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
079709
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000998675
ANTHEM
IN
05
—
201328650A
—
IN
Enumeration date
03/30/2009
Last updated
04/11/2018
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