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Individual

DR. VENKATA MOHAN RAJU LAKKIMSETTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 FREEDOM WAY, CHARLIE NORWOOD AUGUSTA VA, AUGUSTA, GA 30904
(706) 733-0188
Mailing address
1 FREEDOM WAY, CHARLIE NORWOOD AUGUSTA VA, AUGUSTA, GA 30904
(706) 733-0188

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
067138
GA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
101816
FL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/21/2007
Last updated
02/23/2012
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