Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01077267A | IN |
N | 111NI0900X | Internist | 01077267A | IN |
N | 207R00000X | Internist | 4301096381 | MI |
N | 111NI0900X | Internist | 4301096381 | MI |
N | 207RH0000X | Hematologist | 01077267A | IN |
N | 207RH0003X | Hematology & Oncology | 01077267A | IN |
Y | 207RX0202X | Medical Oncology | 01077267A | IN |
NPI | 1265745145 |
---|---|
Provider Name | Praveen Ranganath |
First Address | Indianapolis, IN 46268-3129 |
Second Address | Anderson, IN 46016-4338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2010 |
Last Update Date | 27/07/2016 |