Individual
NATARAJAN MANICKAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
270 SMITH CHURCH ROAD, ROANOKE RAPIDS, NC 27870-4914
(252) 537-0134
(252) 537-6515
Mailing address
270 SMITH CHURCH ROAD, ROANOKE RAPIDS, NC 27870-4914
(252) 537-0134
(252) 537-6515
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
32778
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028182
VABCBS
VA
01
—
110179483
RAIL ROAD MEDICARE
—
01
—
18619
CAPITOL BC PENN
—
01
—
20384900
DIVISION OF COAL MINERS
—
01
—
40991
MEDCOST
—
01
—
48 55339
UNITED HEALTHCARE
—
01
—
53872
BCBSNC
NC
01
—
5843073
VIRGINIA MEDICAID
—
05
—
8953972
—
NC
Enumeration date
11/13/2006
Last updated
12/01/2009
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