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Individual

PRAVEEN VENIGALLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3900 ST FRANCIS WAY STE 200, LAFAYETTE, IN 47905-4940
(765) 775-2800
(765) 775-2831
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01092317A
IN
207R00000X
Internal Medicine Physician
2017-00547
NC
207RC0000X
Cardiovascular Disease Physician
Primary
01092317A
IN
208M00000X
Hospitalist Physician
52426
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NC3370
SC
Enumeration date
06/07/2011
Last updated
03/17/2026
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