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Individual

DR. RAJ K MATURI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11220 ILLINOIS ST STE 110, CARMEL, IN 46032-8887
(317) 817-1414
(317) 805-4587
Mailing address
11220 ILLINOIS ST STE 110, CARMEL, IN 46032-9847
(317) 817-1414
(317) 805-4587

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01050295
IN
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
01050295
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000196897
ANTHEM BCBS PIN
IN
01
180042424
RAILROAD MEDICARE PIN
IN
05
200216230
IN
01
352076654
TAX ID
IN
01
5134 724
AETNA PROVIDER ID
IN
Enumeration date
06/22/2005
Last updated
01/14/2026
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