Provider Demographics
NPI:1609046655
Name:DAMERLA, VENUGOPAL RAO (MD)
Entity Type:Individual
Prefix:
First Name:VENUGOPAL
Middle Name:RAO
Last Name:DAMERLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 CLERMONT ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3808
Mailing Address - Country:US
Mailing Address - Phone:303-765-3485
Mailing Address - Fax:303-765-3486
Practice Address - Street 1:5200 HAHNS PEAK DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-8852
Practice Address - Country:US
Practice Address - Phone:970-962-4900
Practice Address - Fax:970-962-4901
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO48891207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine