Individual
GOUTHAMI RATNA CHENNU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
445 CHARLES H DIMMOCK PKWY STE 100, COLONIAL HEIGHTS, VA 23834-2990
(804) 520-1764
Mailing address
445 CHARLES H DIMMOCK PKWY STE 100, COLONIAL HEIGHTS, VA 23834-2990
(804) 520-1764
(804) 616-4221
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA1102000
NJ
207RC0000X
Cardiovascular Disease Physician
0101285139
VA
207RI0011X
Interventional Cardiology Physician
Primary
0101285139
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
03/20/2018
Last updated
08/08/2025
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