Dinesh Ven Koba Raju (NPI# 1548465198, PAC ID# 4587831151) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEUROLOGY.
| Nation Provider ID (NPI) | 1548465198 |
| PAC ID by PECOS | 4587831151 |
| Professional Enrollment ID | I20120123000423 |
| Full Name | Dinesh Ven Koba Raju |
| Organization Legal Name | GWINNETT CLINIC,LTD |
| Address |
2650 Lawrenceville Suwanee Rd Suite B Suwanee GA 30024-2535 |
| Phone Number | 6782055000 |
| Gender | M |
| Medical School | EMORY UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2007 |
| Primary Specialty | NEUROLOGY |
| Group Practice PAC ID | 9436061801 |
| Number of Group Practice Members | 38 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110087 | GWINNETT MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 475 Philip Blvd, Suite 100, Lawrenceville, GA 30046-8736 | 7709953300 | GWINNETT CLINIC,LTD |
| 2650 Lawrenceville Suwanee Rd, Suite B, Suwanee, GA 30024-2535 | 6782055000 | GWINNETT CLINIC,LTD |
| Organization Legal Name | GWINNETT CLINIC,LTD |
| Physicians | 33 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deep Jayendrakumar Shah | Internal Medicine | Gwinnett Clinic,ltd | 2650 Lawrenceville Suwanee Rd, Suite B, Suwanee, GA 30024-2535 |
| Anthony Pothoulakis | Cardiovascular Disease (cardiology) | Gwinnett Clinic,ltd | 1289 Scenic Hwy, Lawrenceville, GA 30045-6358 |
| Asha Jayendrakumar Shah | Internal Medicine | Gwinnett Clinic,ltd | 4870 Lawrenceville Hwy, Tucker, GA 30084-2952 |
| Raja Ram | Family Medicine | Gwinnett Clinic,ltd | 2327 Hwy 29, Dacula, GA 30019-2205 |
| Gabriel Nguena | Internal Medicine | Gwinnett Clinic,ltd | 5595 Peachtree Pkwy, Norcross, GA 30092-2551 |
| Ned B Armstrong | Orthopedic Surgery | Gwinnett Clinic,ltd | 475 Philip Blvd, Suite 100, Lawrenceville, GA 30046-8736 |
| Min-jie Tan | Internal Medicine | Gwinnett Clinic,ltd | 475 Philip Blvd, Suite 100, Lawrenceville, GA 30046-8736 |
| Nishith H Oza | Physical Therapy | Gwinnett Clinic,ltd | 475 Philip Blvd, Suite 100, Lawrenceville, GA 30046-8736 |
| Jessica A Etzkorn | Nurse Practitioner | Gwinnett Clinic,ltd | 475 Philip Blvd, Suite 100, Lawrenceville, GA 30046-8736 |
| Ashlyn Ciara Clay | Nurse Practitioner | Gwinnett Clinic,ltd | 475 Philip Blvd, Suite 100, Lawrenceville, GA 30046-8736 |
| Street Address |
2650 LAWRENCEVILLE SUWANEE RD SUITE B |
| City | SUWANEE |
| State | GA |
| Zip | 30024-2535 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deep Jayendrakumar Shah | Internal Medicine | Gwinnett Clinic,ltd | 2650 Lawrenceville Suwanee Rd, Suite B, Suwanee, GA 30024-2535 |
| Jayendrakumar J Shah | Orthopedic Surgery | Gwinnett Clinic,ltd | 2650 Lawrenceville Suwanee Rd, Suite B, Suwanee, GA 30024-2535 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jessica Christine Allen | Qualified Audiologist | Johns Creek Audiology | 203 Woodpark Place, Suite B 100, Woodstock, GA 30024 |
| John Yozen Shih | Family Medicine | 960 Ptree Industrial Blvd, Suwanee, GA 30024 | |
| Benjamin Laremont | Family Practice | Maternal and Family Medicine Ctr | 1630 Peachstreet Industrial Blvd A, Suwanee, GA 30024 |
| Christin Brooke Means | Qualified Audiologist | Johns Creek Audiology | 203 Woodpark Place, Suite B 100, Woodstock, GA 30024 |
| Deborah T Woodward | Qualified Audiologist | Johns Creek Audiology | 203 Woodpark Place, Suite B 100, Woodstock, GA 30024 |
| Sae J Kim | Physical Therapy | 1325 Satellite Nwblvd, Suite 1302, Suwanee, GA 30024 | |
| Sarah O Licht | Qualified Audiologist | Johns Creek Audiology | 203 Woodpark Place, Suite B 100, Woodstock, GA 30024 |
| Christa Barefoot Nelms | Audiologist | Johns Creek Audiology | 203 Woodpark Place, Suite B 100, Woodstock, GA 30024 |
| Joshua Hasty | Chiropractic | 2615 Peachtree Pkwy, Suite 270, Suwanee, GA 30024-1050 | |
| Malcolm M Traxler Jr. | Internal Medicine | Evergreen Primary Care and Wellness PC | 3000 Celebration Blvd, Suwanee, GA 30024-1054 |
| Find all physicians in zip 30024 | |||
| City | SUWANEE |
| Zip Code | 30024 |
| Specialty | NEUROLOGY |
| City + Specialty | SUWANEE + NEUROLOGY |
Please comment or provide details below to improve the information on Dinesh Ven Koba Raju.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.