Individual
DR. VENKAT PRIDHVI NUTALAPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
11311 BRIDGEPORT WAY SW STE 207, LAKEWOOD, WA 98499-3051
(253) 272-8664
(253) 627-7880
Mailing address
11311 BRIDGEPORT WAY SW STE 207, LAKEWOOD, WA 98499-3051
(253) 272-8664
(253) 627-7880
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-38964
KS
207RG0100X
Gastroenterology Physician
2025013233
MO
207RG0100X
Gastroenterology Physician
Primary
MD61274732
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2211808
—
WA
Enumeration date
06/26/2013
Last updated
09/02/2025
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