Provider Demographics
NPI:1699303081
Name:VARRE, JAYA SAI VENKATA (MD)
Entity type:Individual
Prefix:
First Name:JAYA SAI
Middle Name:VENKATA
Last Name:VARRE
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 1:3595 OLENTANGY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3440
Mailing Address - Country:US
Mailing Address - Phone:614-566-5456
Mailing Address - Fax:
Practice Address - Street 1:3595 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3440
Practice Address - Country:US
Practice Address - Phone:614-566-5456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program