Devanathan, Raja G

Devanathan, Raja G is an individual health care provider with primary practice located at 7875 Grand Blvd , Hobart IN 46342-6665. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Devanathan, Raja G can be contacted via phone (219) 942-9658.

Contact Information

Primary practice address
7875 Grand Blvd Hobart IN 46342-6665
Fax: (219) 947-1996
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 01040141 Indiana

Profile Details

NPI number 1871587220
LBN Legal business name Devanathan, Raja G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Aug 5th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871587220 NPPES
Indiana MEDICAID 100379600A

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