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VENU M. MADHIPATLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
455 PHILIP BLVD STE 140, LAWRENCEVILLE, GA 30046-8768
(770) 962-3642
(770) 962-3643
Mailing address
455 PHILIP BLVD STE 140, LAWRENCEVILLE, GA 30046-8768
(770) 962-3642
(770) 962-3643

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
65559
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
065559
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
65559
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
65559
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003104831A
GA
05
003104831N
GA
05
200973980
IN
05
7100117730
KY
Enumeration date
12/11/2006
Last updated
10/01/2024
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