Provider Demographics
NPI:1427241926
Name:HANDRATTA, VENKATESH DHANANJAY (MD)
Entity type:Individual
Prefix:DR
First Name:VENKATESH
Middle Name:DHANANJAY
Last Name:HANDRATTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WALTER REED NATIONAL MILITARY MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5630
Mailing Address - Country:US
Mailing Address - Phone:301-400-1457
Mailing Address - Fax:301-295-6720
Practice Address - Street 1:4954 N PALMER RD BLDG 19
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5630
Practice Address - Country:US
Practice Address - Phone:301-400-1457
Practice Address - Fax:301-295-6720
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00671882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid
MDD0067188OtherSTATE LICENSE
MDD0067188OtherSTATE LICENSE
MDS118Medicare PIN