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Individual

MR. MAHENDRA C MARU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
33042
KY
207RN0300X
Nephrology Physician
Primary
33042
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000067006
ANTHEM PIN
IN
01
000000067006
ANTHEM
KY
05
200145790
IN
05
64330426
KY
01
CJ7612
RAILROAD MEDICARE
IN
01
CJ7612
RAILROAD MEDICARE
KY
Enumeration date
07/05/2005
Last updated
06/23/2015
Update your record

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