Kanubaddi, Venkateswara R
Kanubaddi, Venkateswara R is an individual health care provider with primary practice located at 2121 Lake Ave , Fort Wayne IN 46805-5100. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Kanubaddi, Venkateswara R can be contacted via phone (260) 426-5431.Contact Information
Primary practice address
2121 Lake Ave
Fort Wayne IN 46805-5100
Phone: (260) 426-5431
Fax: (260) 460-1383
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 01028849A | Indiana |
Profile Details
| NPI number | 1750388955 |
|---|---|
| LBN Legal business name | Kanubaddi, Venkateswara R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 1st, 2005 |
| Last updated | Jun 18th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750388955 | NPPES |
| Indiana | Other | 000000082079 | ANTHEM BC/BC |
| Indiana | MEDICAID | 100323110A | ANTHEM BC/BC |
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