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NPI Code Detail

MEDICARE: DR. DORAISAMY VENKITAPATHY M.D.

MEDICARE: DR. DORAISAMY VENKITAPATHY M.D.
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 Physician4301060380MI

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 : 1922132539
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DORAISAMY VENKITAPATHY M.D.
Provider Business Mailing Address
First Line : 10 SAWMILL CREEK TRL
Second Line :
City : SAGINAW
State : MI
Zip : 48603-8626
Country : US
Telephone Number : 989-846-4521
Fax Number : 989-846-3541
Provider Business Practice Location Address
First Line : 805 W CEDAR ST
Second Line :
City : STANDISH
State : MI
Zip : 48658-9526
Country : US
Telephone Number : 989-846-3401
Fax Number : 989-846-3541
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 07/08/2007

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