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Individual
VIJAYA R. THEKKEURUMBIL
Active
Individual
VIJAYA R. THEKKEURUMBIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34848
TN
208M00000X
Hospitalist Physician
44167
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10015751
OMNICARE TENNCARE
TN
01
—
21060
TLC TENNCARE
TN
05
—
3862507
—
TN
05
—
3862508
—
TN
05
—
3862509
—
TN
01
—
4001211
BLUE CROSS
TN
01
—
4013849
BLUE CROSS
TN
01
—
50004635
PASSPORT HEALTH PLAN
KY
05
—
64029556
—
KY
01
—
930113083
MEDICARE RAILROAD
TN
01
—
P00186020
MEDICARE RAILROAD
TN
01
—
P00384333
MEDICARE RAILROAD
TN
Enumeration date
06/19/2006
Last updated
10/07/2019
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