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General NPI Number Information
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NPI Number | 1013207208
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Entity Type | Individual
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Provider Name | VISHNU CHOUDHARY POTINI MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2011
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 90 BERGEN ST DOC SUITE 7300
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City | NEWARK
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State | NJ
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Zip | 07103-2425
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Country | US
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Telephone | 973-972-2150
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 MANCHESTER EXPY STE 101A
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City | COLUMBUS
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State | GA
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Zip | 31904-6802
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Country | US
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Telephone | 706-320-3128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 2749-320
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 078464
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License Number State | GA
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