Individual
DEVI PRASAD BOTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 W, RAVINE RD., KINGSPORT, TN 37660
(423) 224-3450
(423) 224-3458
Mailing address
119 BOONE RIDGE DRIVE, SUITE 201, JOHNSON CITY, TN 37615
(423) 282-1480
(423) 928-1353
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
47660
TN
208M00000X
Hospitalist Physician
47660
TN
Other
Enumeration date
09/24/2008
Last updated
10/17/2011
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