Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 25MA07142700 | NJ |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 25MA07142700 | NJ |
NPI | 1285613133 |
---|---|
Provider Name | Devender N Akula |
First Address | Egg Harbor Township, NJ 08234 |
Second Address | Egg Harbor Township, NJ 08234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 13/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0069264 | (05) | NJ |
091512 | MEDICARE PTAN (01) | NJ |
I17268 | (02) |