Organization
ALTOONA INTERNAL MEDICINE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VENKATA RAMA RAJU PERICHERLA M.D. (PRESIDENT)
(814) 946-1818
Entity
Organization
Contact information
Practice address
1710 6TH AVE, ALTOONA, PA 16602-2324
(814) 946-1818
(814) 569-3039
Mailing address
PO BOX 482, HOLLIDAYSBURG, PA 16648-0482
(814) 946-1818
(814) 569-3039
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD064819L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018859820006
—
PA
01
—
185780
HEALTH ASSURANCE NUMBER
PA
01
—
202690
UPMC GROUP NUMBER
PA
01
—
DB5128
RAILROAD MEDICARE NUMBER
PA
01
—
W462
GEISINGER NUMBER
PA
Enumeration date
08/02/2006
Last updated
08/22/2020
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