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NPI Code Detail

MEDICARE: DR. VENKATRAM NETHALA M.D.

MEDICARE: DR. VENKATRAM NETHALA M.D.
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
1207RC0000XCardiovascular Disease Physician8994NH
2207RC0000XCardiovascular Disease PhysicianTD101035ME
3207RC0000XCardiovascular Disease Physician018751ME

General Provider Information

NPI Number : 1427158716
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VENKATRAM NETHALA M.D.
Provider Business Mailing Address
First Line : 935 WAYNE RD
Second Line :
City : SAVANNAH
State : TN
Zip : 38372-1904
Country : US
Telephone Number : 731-926-8000
Fax Number : 731-926-8303
Provider Business Practice Location Address
First Line : 935 WAYNE RD
Second Line :
City : SAVANNAH
State : TN
Zip : 38372-1904
Country : US
Telephone Number : 731-926-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 12/15/2023

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