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NPI Code Detail

MEDICARE: DR. MALATHI VENKATESAN MD

MEDICARE:  DR. MALATHI  VENKATESAN  MD
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
1207R00000XInternal Medicine PhysicianMD67038GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1001518398OTHERHIGHMARK
21536140OTHERGATEWAY
31784451OTHERUNITED HEALTHCARE
46709237003OTHERCIGNA
53359545OTHERAETNA
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7043771728OTHERHEALTH AMERICA
8145688OTHERUNISON
9200195OTHERUPMC
1014517OTHERELDER HEALTH

General Provider Information

NPI Number : 1861403057
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MALATHI VENKATESAN MD
Provider Business Mailing Address
First Line : 1845 SATELLITE BLVD
Second Line : SUITE 500
City : DULUTH
State : GA
Zip : 30097-5256
Country : US
Telephone Number : 404-778-5220
Fax Number : 404-778-6451
Provider Business Practice Location Address
First Line : 1845 SATELLITE BLVD
Second Line : SUITE 500
City : DULUTH
State : GA
Zip : 30097-5256
Country : US
Telephone Number : 404-778-5220
Fax Number : 404-778-6451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 08/29/2014

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Directions to “ DR. MALATHI VENKATESAN MD” Practice Location

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