Healthcare Provider Details

I. General information

NPI: 1770767527
Provider Name (Legal Business Name): DEVIPRASAD VENUGOPAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 TATE BLVD SE
HICKORY NC
28602-1465
US

IV. Provider business mailing address

2660 TATE BLVD SE
HICKORY NC
28602-1465
US

V. Phone/Fax

Practice location:
  • Phone: 828-261-0009
  • Fax:
Mailing address:
  • Phone: 828-261-0009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2026-00164
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number2026-00164
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: