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General NPI Number Information
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NPI Number | 1043291933
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Entity Type | Individual
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Provider Name | VENKATA AMILINENI MD
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Gender | Male
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 1325 SPRING ST
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City | GREENWOOD
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State | SC
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Zip | 29646-3860
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Country | US
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Telephone | 864-725-4111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2898
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City | ABILENE
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State | TX
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Zip | 79604-2898
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Country | US
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Telephone | 325-677-2201
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Fax | 325-677-7641
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | L4218
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 91412
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License Number State | SC
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