Individual
DARUKA MAHADEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
7979 WURZBACH RD, SAN ANTONIO, TX 78229-4427
(210) 450-1143
(210) 450-0407
Mailing address
7979 WURZBACH RD, SAN ANTONIO, TX 78229-4427
(210) 450-1143
(210) 450-0407
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
S4811
TX
207RH0003X
Hematology & Oncology Physician
30621
AZ
207RX0202X
Medical Oncology Physician
Primary
S4811
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408576301
—
TX
01
—
408576302
CSHCN
TX
05
—
721599
—
AZ
Enumeration date
09/20/2006
Last updated
12/18/2020
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