Healthcare Provider Details

I. General information

NPI: 1528118775
Provider Name (Legal Business Name): VENKATARAO NEELATI M.D.,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W MAIN ST
COLDWATER OH
45828-1613
US

IV. Provider business mailing address

800 W MAIN ST
COLDWATER OH
45828-1613
US

V. Phone/Fax

Practice location:
  • Phone: 419-678-2341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35069644N
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: