Individual
VIJAI KUMAR DORAIRAJ DHARLA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7165 CLEARVISTA WAY, INDIANAPOLIS, IN 46256-4621
(317) 621-5700
Mailing address
7165 CLEARVISTA WAY, INDIANAPOLIS, IN 46256-4621
(317) 621-5700
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11022870A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300075620
—
IN
Enumeration date
03/27/2023
Last updated
05/30/2023
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