Mahidhara, Raja S

Mahidhara, Raja S is an individual health care provider with primary practice located at 3900 St Francis Way Ste 200 , Lafayette IN 47905-4940. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Mahidhara, Raja S can be contacted via phone (765) 775-2800.

Contact Information

Primary practice address
3900 St Francis Way Ste 200 Lafayette IN 47905-4940
Phone: (765) 775-2800
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 01070300A Indiana
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 01070300A Indiana

Profile Details

NPI number 1689771016
LBN Legal business name Mahidhara, Raja S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Mar 11th, 2021 - about 4 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 1689771016 NPPES
Indiana MEDICAID 201037400

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