Individual
JAGANNATH HEREMAGALUR SAIKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2730
Mailing address
956 COURT AVE, COLEMAN BLDG, MEMPHIS, TN 38103-2814
(419) 215-0586
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
50178
TN
207R00000X
Internal Medicine Physician
MD60801533
WA
207RN0300X
Nephrology Physician
50178
TN
207RN0300X
Nephrology Physician
Primary
MD60801533
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1533280
—
TN
05
—
199530001
—
AR
Enumeration date
07/16/2008
Last updated
03/17/2018
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