Individual
DR. VENU GOURINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
460 NORTHSIDE CHEROKEE BLVD STE 150, CANTON, GA 30115-8018
(470) 639-6250
(770) 345-0712
Mailing address
460 NORTHSIDE CHEROKEE BLVD STE 150, CANTON, GA 30115-8018
(470) 639-6250
(770) 345-0712
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
#4301094579
MI
207R00000X
Internal Medicine Physician
MT187681
PA
207RC0000X
Cardiovascular Disease Physician
100195
GA
207RC0000X
Cardiovascular Disease Physician
Primary
4301094579
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154473635
—
MI
Enumeration date
01/17/2007
Last updated
06/27/2024
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