Provider Demographics
NPI:1447228887
Name:VENKAT, HEMA (MD)
Entity Type:Individual
Prefix:
First Name:HEMA
Middle Name:
Last Name:VENKAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32615
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48232-0615
Mailing Address - Country:US
Mailing Address - Phone:313-593-7965
Mailing Address - Fax:313-593-7143
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:OAKWOOD HOSPITAL MEDICAL CENTER
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:313-593-7965
Practice Address - Fax:313-593-7143
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI040075207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1821555Medicaid
MI1821555Medicaid