1952741407 NPI number — DR. VENKATA SUSHMA CHAMARTHI M.D.

Table of content: DR. VENKATA SUSHMA CHAMARTHI M.D. (NPI 1952741407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952741407 NPI number — DR. VENKATA SUSHMA CHAMARTHI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAMARTHI
Provider First Name:
VENKATA SUSHMA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952741407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3636 N 1ST ST STE 120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93726-6818
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-224-4365
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DAKOTA PEDIATRICS
Provider Second Line Business Practice Location Address:
3636 N. FIRST STREET, SUITE 120
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-224-4365
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  A148613 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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