Pendyala, Venkata Susrut

Pendyala, Venkata Susrut is an individual health care provider with primary practice located at 1100 Goethals Dr Ste F , Richland WA 99352-3301. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Pendyala, Venkata Susrut can be contacted via phone (509) 942-3272.

Contact Information

Primary practice address
1100 Goethals Dr Ste F Richland WA 99352-3301
Phone: (509) 942-3272
Fax: (509) 942-3273
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-138524 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD61171799 Washington
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD61171799 Washington
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X MD61171799 Washington

Profile Details

NPI number 1831444553
LBN Legal business name Pendyala, Venkata Susrut
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2012
Last updated Sep 20th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831444553 NPPES
Illinois MEDICAID 036138524

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