Provider Demographics
NPI:1821256264
Name:KOLLENGODE VENKITACHALAPATHY, SANTHI (MBBS, MD)
Entity Type:Individual
Prefix:DR
First Name:SANTHI
Middle Name:
Last Name:KOLLENGODE VENKITACHALAPATHY
Suffix:
Gender:F
Credentials:MBBS, MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:69 JESSE HILL JR DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3033
Mailing Address - Country:US
Mailing Address - Phone:404-616-7028
Mailing Address - Fax:404-525-2957
Practice Address - Street 1:69 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3033
Practice Address - Country:US
Practice Address - Phone:404-616-7028
Practice Address - Fax:404-525-2957
Is Sole Proprietor?:No
Enumeration Date:2008-05-31
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA003388207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine