Individual
USHA VENKATRAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2400 UNSER BLVD SE, RIO RANCHO, NM 87124-4740
(505) 559-6100
(505) 559-6101
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
K6395
TX
207RH0003X
Hematology & Oncology Physician
Primary
MD2018-0002
NM
207RX0202X
Medical Oncology Physician
K6395
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68171773
—
NM
Enumeration date
07/16/2006
Last updated
01/30/2018
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