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NPI Code Detail

MEDICARE: VENKATA AMILINENI MD

MEDICARE: VENKATA AMILINENI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianL4218TX
22085R0202XDiagnostic Radiology Physician91412SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043291933
Entity Type Code : Individual
Provider Name (Legal Business Name) : VENKATA AMILINENI MD
Provider Business Mailing Address
First Line : PO BOX 2898
Second Line :
City : ABILENE
State : TX
Zip : 79604-2898
Country : US
Telephone Number : 325-677-2201
Fax Number : 325-677-7641
Provider Business Practice Location Address
First Line : 1325 SPRING ST
Second Line :
City : GREENWOOD
State : SC
Zip : 29646-3860
Country : US
Telephone Number : 864-725-4111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 02/07/2024

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Directions to “ VENKATA AMILINENI MD” Practice Location

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