Venkatraman Sadanand, MD | |
305 E Jefferson St, Boise, ID 83712-6231 | |
(208) 381-7360 | |
Not Available |
Full Name | Venkatraman Sadanand |
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Gender | Male |
Speciality | Surgery - Pediatric Surgery |
Location | 305 E Jefferson St, Boise, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497741417 | NPI | - | NPPES |
036-110940 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2086S0120X | Surgery - Pediatric Surgery | M-17274 (Idaho) | Primary |
2086S0120X | Surgery - Pediatric Surgery | 036-110940 (Illinois) | Secondary |
Entity Name | St Lukes Clinic-treasure Valley Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
Mailing Address | Practice Location Address |
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Venkatraman Sadanand, MD 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Venkatraman Sadanand, MD 305 E Jefferson St, Boise, ID 83712-6231 Ph: (208) 381-7360 |
Dr. Craig B. Bass, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 250 Bobwhite Ct, # 275, Boise, ID 83706 Phone: 208-333-0200 Fax: 208-333-0399 | |
Aziz George Munayirji, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 999 N Curtis Rd, Suite 415, Boise, ID 83706 Phone: 208-367-7676 Fax: 208-367-5595 | |
John M Livingston, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 8756 W Emerald St, Suite 136, Boise, ID 83704 Phone: 208-853-3051 Fax: 208-853-3053 | |
Jason A Kemp, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 222 N 2nd St, Suite 202, Boise, ID 83702 Phone: 208-381-6390 Fax: 208-381-6395 | |
Dr. Patrick Cole, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1070 N Curtis Rd Ste 135, Boise, ID 83706 Phone: 208-947-5390 Fax: 208-947-3465 | |
Dr. Graham W Donald, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 333 N 1st St Ste 280, Boise, ID 83702 Phone: 208-345-6545 Fax: 208-345-1213 | |
Courtney Alyson Green, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 999 N Curtis Rd Ste 415, Boise, ID 83706 Phone: 208-302-2600 Fax: 208-302-2625 |