Individual
VENKATRAMAN SADANAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 381-7360
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
036-110940
IL
2086S0120X
Pediatric Surgery Physician
Primary
M-17274
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-110940
—
IL
Enumeration date
09/26/2005
Last updated
11/27/2023
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