Individual
DR. VENKATESHWER RAO ROUTHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
(770) 224-1000
(770) 224-2451
Mailing address
905 WATERFORD LNDG, MCDONOUGH, GA 30253-7717
(770) 957-0638
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
045944
GA
207R00000X
Internal Medicine Physician
MD-44995
IA
207R00000X
Internal Medicine Physician
MD0000058021
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000870416A
—
GA
Enumeration date
04/11/2007
Last updated
06/08/2020
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