Provider Demographics
NPI:1437437498
Name:POTHINENI, NAGA VENKATA KRISHNA CHAND (MD)
Entity Type:Individual
Prefix:
First Name:NAGA VENKATA
Middle Name:KRISHNA CHAND
Last Name:POTHINENI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N UNIVERSITY AVE
Mailing Address - Street 2:APT # 510
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3121
Mailing Address - Country:US
Mailing Address - Phone:612-516-1856
Mailing Address - Fax:
Practice Address - Street 1:4301 W MARKHAM ST # 532
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-5392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-8434207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease