Individual
VISWESWARA REDDY VENNAPUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 6TH AVE, DES MOINES, IA 50314-2613
(515) 247-4240
(515) 247-4239
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(515) 247-4240
(515) 247-4239
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37247
IA
207R00000X
Internal Medicine Physician
MD-37247
IA
208M00000X
Hospitalist Physician
Primary
MD-37247
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558586826
—
IA
01
—
55457
WELLMARK BLUE SHIELD
IA
Enumeration date
04/13/2007
Last updated
11/09/2017
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