Individual
DR. NEETHU VEDANTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4 SHERIDAN SQ STE 200, KINGSPORT, TN 37660-7435
(423) 246-7931
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
65494
TN
207RI0200X
Infectious Disease Physician
Primary
65494
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q042551
—
TN
Enumeration date
06/20/2017
Last updated
01/29/2024
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