Individual
NIRANJANA RAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
930 PARK DR, STE GENEVIEVE, MO 63670-1539
(573) 883-7474
Mailing address
PO BOX 366, STE GENEVIEVE, MO 63670-0366
(573) 883-4477
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MOR6A98
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0450220
UHC
MO
01
—
060023232
RAILROAD MEDICARE
MO
01
—
193294
HEALTHLINK
MO
05
—
201290004
—
MO
01
—
23094
BLUE CHOICE
MO
01
—
36162
BCBS
MO
01
—
4574132
AETNA
MO
01
—
46047
HEALTHCARE USA
MO
01
—
999554
COMMUNITY CARE PLUS
MO
01
—
A11284
MERCY HEALTH
MO
Enumeration date
02/13/2006
Last updated
03/15/2017
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