Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | 036118248 | IL |
N | 207RG0100X | Gastroenterologist | 54610 | WI |
Y | 207RG0100X | Gastroenterologist | MD60385630 | WA |
NPI | 1013135912 |
---|---|
Provider Name | Dr. Nanda Venu |
First Address | Seattle, WA 98101-2756 |
Second Address | Seattle, WA 98101-2756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 12/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013135912 | (05) | WI |