Provider Demographics
NPI:1710095369
Name:CHITTURI, VENKATA KRISHNA SURESH (MD)
Entity Type:Individual
Prefix:DR
First Name:VENKATA
Middle Name:KRISHNA SURESH
Last Name:CHITTURI
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 1:300 STONECREST BLVD STE 365
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6819
Mailing Address - Country:US
Mailing Address - Phone:615-768-4300
Mailing Address - Fax:615-768-4400
Practice Address - Street 1:300 STONECREST BLVD STE 365
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6819
Practice Address - Country:US
Practice Address - Phone:615-768-4300
Practice Address - Fax:615-768-4400
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4798912084N0400X
MI43010750052084N0400X
KY460642084N0400X
TN438512084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1514160Medicaid
TN1514159Medicaid
DP2466OtherRAILROAD MEDICARE
4228993OtherBCBST
30417991Medicare PIN
3041799Medicare PIN