Individual
VENKATA RAMA PRASAD NALAMOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 432-2297
(260) 434-6433
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01061122A
IN
207UN0901X
Nuclear Cardiology Physician
Primary
01061122A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000380848
ANTHEM
IN
05
—
200540940
—
IN
05
—
2657085
—
OH
01
—
P00276052
RAILROAD
—
01
—
P00783751
RAILROAD
IN
Enumeration date
01/23/2006
Last updated
09/29/2020
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