Individual
VIJOYDEEP TANJORE VENKOBA RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
434 4TH ST STE 201, NEWPORT, TN 37821-3736
(423) 613-1660
(423) 613-1661
Mailing address
434 4TH ST STE 201, NEWPORT, TN 37821-3736
(423) 613-1660
(423) 613-1661
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11393R
LA
207RP1001X
Pulmonary Disease Physician
Primary
48284
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528818
—
TN
Enumeration date
09/26/2006
Last updated
09/10/2020
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