Provider Demographics
NPI:1619945953
Name:MOTAPARTHY, VENKATASOMAIAH CHOUDARY (MD)
Entity Type:Individual
Prefix:DR
First Name:VENKATASOMAIAH
Middle Name:CHOUDARY
Last Name:MOTAPARTHY
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 1:2705 MEDICAL OFFICE PL
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-9458
Mailing Address - Country:US
Mailing Address - Phone:919-731-2526
Mailing Address - Fax:919-580-0988
Practice Address - Street 1:2705 MEDICAL OFFICE PL
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9458
Practice Address - Country:US
Practice Address - Phone:919-731-2526
Practice Address - Fax:919-580-0988
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25379207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890125QMedicaid
NC202918Medicare ID - Type Unspecified