Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 44239 | KY |
N | 111NI0900X | Internist | 44239 | KY |
NPI | 1003077785 |
---|---|
Provider Name | Padma Venkatraman |
First Address | Ashland, KY 41102-8610 |
Second Address | Ashland, KY 41101-7001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2008 |
Last Update Date | 17/08/2017 |