Individual
KUMAR VENKATACHALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8895 BROADWAY, MERRILLVILLE, IN 46410-7037
(219) 738-2081
(219) 736-4658
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01048257A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085025
ANTHEM BC/BS
IN
01
—
110168975
RAILROAD MEDICARE
IN
05
—
200180870A
—
IN
01
—
9115389
ANTHEM BC/BS
IL
Enumeration date
06/02/2005
Last updated
05/06/2020
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