Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 2016031052 | MO |
NPI | 1033559604 |
---|---|
Provider Name | Dr. Venkata Sai B Chinnakotla |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, SC 29229-7613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2013 |
Last Update Date | 28/07/2021 |