Individual
DR. NATRAJ REDDY AMMAKKANAVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
7979 N SHADELAND AVE, STE 200, INDIANAPOLIS, IN 46250-2042
(317) 621-4300
(317) 621-4301
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-4300
(317) 621-4301
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
01070925A
IN
207RX0202X
Medical Oncology Physician
Primary
01070925A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000943086
ANTHEM
IN
05
—
201125110
—
IN
01
—
P01512377
RAILROAD MEDICARE
IN
01
—
P01751209
RR MEDICARE
IN
Enumeration date
09/10/2010
Last updated
09/06/2023
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