Individual
AYESHA VENKATESWARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
436 5TH AVENUE, KOTZEBUE, AK 99752-0043
(907) 442-3321
Mailing address
PO BOX 43, KOTZEBUE, AK 99752-0043
(907) 442-3321
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
69730
AZ
207Q00000X
Family Medicine Physician
MD60746395
WA
208M00000X
Hospitalist Physician
Primary
2021048199
MO
Other
Enumeration date
06/09/2014
Last updated
12/30/2024
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