Provider Demographics
NPI:1477768018
Name:SETTY, JANAKIRAM
Entity Type:Individual
Prefix:DR
First Name:JANAKIRAM
Middle Name:
Last Name:SETTY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JANAKIRAM
Other - Middle Name:
Other - Last Name:SETTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:217 STAFFORDSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-2719
Mailing Address - Country:US
Mailing Address - Phone:336-768-5394
Mailing Address - Fax:336-768-5394
Practice Address - Street 1:217 STAFFORDSHIRE RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-2719
Practice Address - Country:US
Practice Address - Phone:336-768-5394
Practice Address - Fax:336-768-5394
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19284207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC80900Medicare UPIN