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General NPI Number Information
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NPI Number | 1972503027
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Entity Type | Individual
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Provider Name | RADHA VENKATRAMANAN MD
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Gender | Female
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1910 S VIRGINIA ST SUITE 106
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-3692
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Country | US
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Telephone | 270-889-0282
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Fax | 270-887-8340
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Provider Business Mailing Address
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Address Line | PO BOX 73
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City | HOPKINSVILLE
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State | KY
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Zip | 42241-0073
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Country | US
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Telephone | 270-889-0282
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Fax | 270-887-8340
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 39289
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 39324
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License Number State | TN
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