1942253992 NPI number — MONIKA NATARAJAN MD

Table of content: MONIKA NATARAJAN MD (NPI 1942253992)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942253992 NPI number — MONIKA NATARAJAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NATARAJAN
Provider First Name:
MONIKA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942253992
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7645 WOLF RIVER CIR STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GERMANTOWN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38138-1751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-405-0275
Provider Business Mailing Address Fax Number:
901-869-2908

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7645 WOLF RIVER CIR STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GERMANTOWN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38138-1751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-405-0275
Provider Business Practice Location Address Fax Number:
901-869-2908
Provider Enumeration Date:
05/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  35399 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3867904 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7254795 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32093 . This is a "TLC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4052154 . This is a "BCBS OF TENNESSEE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 7608293 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 470882104 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: H47737 . This is a "HEALTHSPRINGS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 470882104 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".




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