Provider Demographics
NPI:1710991682
Name:VENUGOPAL, DHARAPURAM S
Entity Type:Individual
Prefix:
First Name:DHARAPURAM
Middle Name:S
Last Name:VENUGOPAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 WOODRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-1806
Mailing Address - Country:US
Mailing Address - Phone:615-867-6111
Mailing Address - Fax:615-867-5766
Practice Address - Street 1:3400 LEBANON PIKE
Practice Address - Street 2:A.C.Y. CAMPUS, TVHS
Practice Address - City:MURFRESSBORO
Practice Address - State:TN
Practice Address - Zip Code:37129
Practice Address - Country:US
Practice Address - Phone:615-867-6111
Practice Address - Fax:615-867-5766
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000026595207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine