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NPI Code Detail

MEDICARE: VENKATESHWAR K GOTTIPATY MD, PHD

MEDICARE: VENKATESHWAR K GOTTIPATY MD, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician22322SC
2207RC0001XClinical Cardiac Electrophysiology Physician22322SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750329108
Entity Type Code : Individual
Provider Name (Legal Business Name) : VENKATESHWAR K GOTTIPATY MD, PHD
Provider Business Mailing Address
First Line : PO BOX 935722
Second Line :
City : ATLANTA
State : GA
Zip : 31193-5722
Country : US
Telephone Number : 843-792-6200
Fax Number :
Provider Business Practice Location Address
First Line : 2001 LAUREL ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-1018
Country : US
Telephone Number : 803-254-3278
Fax Number : 803-929-3256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2006
Last Update Date : 08/25/2021

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