Individual
YEDATORE S. VENKATESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8 RICHLAND MEDICAL PARK DR STE 420, COLUMBIA, SC 29203-8004
(803) 434-8050
(803) 933-3005
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
34171
SC
2084N0400X
Neurology Physician
7326
NV
2084N0400X
Neurology Physician
AL34171
SC
2084N0600X
Clinical Neurophysiology Physician
7326
NV
2084N0600X
Clinical Neurophysiology Physician
AL34171
SC
2084P0800X
Psychiatry Physician
34171
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100500484
—
NV
05
—
341712
—
SC
Enumeration date
01/04/2006
Last updated
03/07/2023
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