Provider Demographics
NPI:1174019459
Name:BODAPATI VENKATA NAGA, ROHAN CHANDRA KASHYAP (MD)
Entity Type:Individual
Prefix:DR
First Name:ROHAN CHANDRA
Middle Name:KASHYAP
Last Name:BODAPATI VENKATA NAGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROHAN
Other - Middle Name:
Other - Last Name:BODAPATI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-5640
Practice Address - Country:US
Practice Address - Phone:608-263-6400
Practice Address - Fax:608-262-6743
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036156713207R00000X
WI76874208M00000X
IL125072533207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine