Individual
DR. VENU MADHAV KONALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4586 TIMBER RIDGE DR STE 200, DOUGLASVILLE, GA 30135-7514
(770) 942-0457
(770) 942-7699
Mailing address
1835 SAVOY DR STE 300, ATLANTA, GA 30341-1071
(678) 288-9555
(678) 288-9556
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
46646
KY
390200000X
Student in an Organized Health Care Education/Training Program
BP10043399
TX
390200000X
Student in an Organized Health Care Education/Training Program
MT195043
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003268156A
—
GA
01
—
G32296A
MEDICARE PTAN
GA
Enumeration date
12/30/2009
Last updated
07/26/2022
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