Individual
VENKATRAMANA R VATTIPALLY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3264 N EVERGREEN DRIVE NE, GRAND RAPIDS, MI 49525
(616) 363-7272
(616) 361-5828
Mailing address
3264 N EVERGREEN DRIVE NE, GRAND RAPIDS, MI 49525
(616) 363-7272
(616) 361-5828
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
4301072639
MI
2085R0202X
Diagnostic Radiology Physician
Primary
4301072639
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4786020
—
MI
Enumeration date
01/30/2006
Last updated
06/26/2023
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