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1043625478
AJAY VENKATARAM
TACOMA, WA
NPI
1043625478
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: WA MD60715854)
Enumeration Date
2014-06-24
Last Update Date
2022-10-28
Business Address
AJAY VENKATARAM
1717 S J ST STE 336
TACOMA, WA 98405-4933
Phone number: 253-426-4101
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Mailing Address
AJAY VENKATARAM
1810 SUMMIT POINTE DR
SCRANTON, PA 18508
Phone number: 570-877-3988
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