Individual
MEGHANA RAGHAVENDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8111 S EMERSON AVE STE 101, INDIANAPOLIS, IN 46237-8601
(317) 859-5252
(317) 859-5258
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01065387A
IN
207R00000X
Internal Medicine Physician
49640
WI
207RH0003X
Hematology & Oncology Physician
Primary
01065387A
IN
207RX0202X
Medical Oncology Physician
49640
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200916870
—
IN
Enumeration date
08/30/2006
Last updated
09/19/2023
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