Provider Demographics
NPI:1396945804
Name:JONNALAGADDA, VENKATA RAMANAMBA (MD)
Entity type:Individual
Prefix:DR
First Name:VENKATA
Middle Name:RAMANAMBA
Last Name:JONNALAGADDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:502 RED BANKS RD STE A
Mailing Address - Street 2:GREENVILLE PSYCHIATRIC ASSOCIATES, P.A.
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5751
Mailing Address - Country:US
Mailing Address - Phone:252-758-4810
Mailing Address - Fax:
Practice Address - Street 1:502 RED BANKS RD STE A
Practice Address - Street 2:GREENVILLE PSYCHIATRIC ASSOCIATES, P.A.
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5751
Practice Address - Country:US
Practice Address - Phone:252-758-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-011562084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty