Individual
JEYAKUMAR KANDARAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2000
Mailing address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16947
NH
207R00000X
Internal Medicine Physician
40762
WI
208M00000X
Hospitalist Physician
40762
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32599100
—
WI
Enumeration date
09/07/2005
Last updated
01/11/2024
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