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PREETHI KIRAN VENEPALLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
407 W INDIANA AVE, CHESTERTON, IN 46304-2350
(219) 763-8112
(219) 764-5384
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 239-2170
(219) 270-3168

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01072539A
IN
208000000X
Pediatrics Physician
036.128154
IL
208000000X
Pediatrics Physician
A119131
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201174280
IN
Enumeration date
07/02/2008
Last updated
12/12/2023
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