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Individual

RAJALAKSHMY SUNDARARAJAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-7459
(574) 647-3658
Mailing address
3355 DOUGLAS RD, SUITE 300, SOUTH BEND, IN 46635-1781

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01043805A
IN
207R00000X
Internal Medicine Physician
Primary
01043805A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200072630
IN
05
4455706
MI
Enumeration date
11/01/2006
Last updated
09/08/2008
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