Individual
ATIMANAPARAMPIL N. DAMODARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
187 WEXFORD RD, VALPARAISO, IN 46385-8038
(574) 806-4938
Mailing address
187 WEXFORD RD, VALPARAISO, IN 46385-8038
(574) 806-4938
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01028450A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000672956
ANTHEMPROVIDER NUMBER
IN
05
—
100225120
—
IN
01
—
1255394805
NPI NUMBER
IN
01
—
9226652
CIGNA ID NUMBER
—
01
—
M400023747
MEDICARE PTAN NUMBER
IN
Enumeration date
04/06/2006
Last updated
09/16/2020
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