Dr Venkedesh Raju, MD | |
1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | |
(641) 682-7511 | |
Not Available |
Full Name | Dr Venkedesh Raju |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 1001 Pennsylvania Ave, Ottumwa, Iowa |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053512814 | NPI | - | NPPES |
809840 | Other | IL | MEDICARE GROUP PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 125050775 (Illinois) | Secondary |
208000000X | Pediatrics | MD-42748 (Iowa) | Primary |
Entity Name | Ottumwa Health Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386956290 PECOS PAC ID: 3971629924 Enrollment ID: O20100927001257 |
Mailing Address | Practice Location Address |
---|---|
Dr Venkedesh Raju, MD 828 Ne Glen Oak Ave, 204 Stonecrest Apartments, Peoria, IL 61603-3285 Ph: (309) 648-3184 | Dr Venkedesh Raju, MD 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 Ph: (641) 682-7511 |
Dr. William Peyton Miller, MD FAAP Pediatrics Medicare: Medicare Enrolled Practice Location: 1001 Pennsylvania Ave, Ottumwa, IA 52501 Phone: 641-683-3448 | |
Mrs. Lona Welbourn Brager, ARNP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 921 Pennsylvania Ave, Ottumwa, IA 52501 Phone: 641-682-5451 Fax: 641-682-0511 | |
John David Wilson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 931 Pennsylvania Ave, Ottumwa Pediatrics, Ottumwa, IA 52501 Phone: 641-684-3000 Fax: 641-684-2469 | |
Mrs. Ronda Kim Dennis-smithart, M.D.,F.A.A.P. Pediatrics Medicare: Medicare Enrolled Practice Location: 123 E 3rd St Ste 2, Ottumwa, IA 52501 Phone: 641-682-8145 Fax: 641-682-8857 | |
Dr. Hazel Marian Ashraf, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 921 Pennsylvania Ave, Ottumwa, IA 52501 Phone: 641-682-5451 Fax: 641-682-0511 | |
Donalee Wilkins Foster, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 931 Pennsylvania Ave, Ottumwa, IA 52501 Phone: 641-684-3000 Fax: 641-684-2469 |