Provider Demographics
NPI:1801846738
Name:VENKATARAMANA, BALEPUR S (MD)
Entity Type:Individual
Prefix:DR
First Name:BALEPUR
Middle Name:S
Last Name:VENKATARAMANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BALEPUR
Other - Middle Name:
Other - Last Name:VANKATARAMANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:30922 EDGEWATER DRIVE
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958
Mailing Address - Country:US
Mailing Address - Phone:302-542-1669
Mailing Address - Fax:302-644-4167
Practice Address - Street 1:30922 EDGEWATER DRIVE
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958
Practice Address - Country:US
Practice Address - Phone:302-542-1669
Practice Address - Fax:302-644-4167
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10001899207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEB66231Medicare UPIN
DE000001Medicare UPIN