Individual
DR. MAYA KOMMINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
85 E US HIGHWAY 6 STE 300, VALPARAISO, IN 46383
(219) 983-6300
(219) 983-6080
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-3616
(219) 364-3610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
233477
MA
207RC0000X
Cardiovascular Disease Physician
Primary
01075747A
IN
207RC0000X
Cardiovascular Disease Physician
2014-01557
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01373172
MEDICARE RR
NC
Enumeration date
05/28/2008
Last updated
09/11/2020
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