Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 29371 | AZ |
N | 207RC0200X | Critical Care Medicine | 36143759 | IL |
N | 207RC0200X | Critical Care Medicine | D60693 | MD |
N | 207RC0200X | Critical Care Medicine | ME132789 | FL |
N | 207RP1001X | Pulmonary Disease | 29371 | AZ |
N | 207RP1001X | Pulmonary Disease | C53701 | CA |
N | 207RP1001X | Pulmonary Disease | D60693 | MD |
Y | 207RP1001X | Pulmonary Disease | MD61113560 | WA |
NPI | 1073576005 |
---|---|
Provider Name | Sridhar Rajamani |
First Address | Yuma, AZ 85366-6935 |
Second Address | Yuma, AZ 85364-7127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 19/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102096200 | (05) | FL |
595845 | (05) | AZ |
H44361 | (02) | |
KV022 | MEDICARE (01) | FL |