Provider Demographics
NPI:1952396806
Name:VEERAMACHANENI, PADMAJAVANI VENKATA (MD)
Entity type:Individual
Prefix:
First Name:PADMAJAVANI
Middle Name:VENKATA
Last Name:VEERAMACHANENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VANI
Other - Middle Name:
Other - Last Name:VEERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 681508
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1508
Mailing Address - Country:US
Mailing Address - Phone:615-203-8750
Mailing Address - Fax:615-472-8588
Practice Address - Street 1:100 COVEY DR STE 310
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5663
Practice Address - Country:US
Practice Address - Phone:615-203-8750
Practice Address - Fax:615-472-8588
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD30756208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ005643Medicaid
TN3897548Medicaid
TN3897548Medicaid
103I370390Medicare PIN