Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 01070925A | IN |
NPI | 1376850461 |
---|---|
Provider Name | Dr. Natraj Reddy Ammakkanavar |
First Address | Indianapolis, IN 46250-2890 |
Second Address | Indianapolis, IN 46250-2042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2010 |
Last Update Date | 01/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000943086 | ANTHEM (01) | IN |
201125110 | (05) | IN |
P01512377 | RAILROAD MEDICARE (01) | IN |
P01751209 | RR MEDICARE (01) | IN |